401k Plan data: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN plan

MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN
Plan identification number	002

MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT 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

MAUNALANI NURSING AND REHABILITATION CENTER has sponsored the creation of one or more 401k plans.

Company Name: MAUNALANI NURSING AND REHABILITATION CENTER

Employer identification number (EIN): 990249327

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-07-01 SAI CHANTAVY 2023-04-03 SAI CHANTAVY 2023-04-03
002 2020-07-01 SAI CHANTAVY 2022-03-15
002 2020-07-01 SAI CHANTAVY 2022-05-23
002 2020-07-01 SAI CHANTAVY 2022-03-15
002 2019-07-01 SAI CHANTAVY 2021-04-07
002 2018-07-01 SAI CHANTAVY 2020-03-31
002 2017-07-01
002 2017-07-01 SAI CHANTAVY 2020-01-06
002 2016-07-01
002 2016-07-01 SAI CHANTAVY 2019-02-01
002 2015-07-01
002 2014-07-01
002 2013-07-01 CECILE MORRIS
002 2012-07-01 SAI CHANTAVY
002 2011-07-01 SAI CHANTAVY
002 2010-07-01 SAI CHANTAVY
002 2009-07-01 SAI CHANTAVY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-07-01	SAI CHANTAVY	2023-04-03	SAI CHANTAVY	2023-04-03
002	2020-07-01	SAI CHANTAVY	2022-03-15
002	2020-07-01	SAI CHANTAVY	2022-05-23
002	2020-07-01	SAI CHANTAVY	2022-03-15
002	2019-07-01	SAI CHANTAVY	2021-04-07
002	2018-07-01	SAI CHANTAVY	2020-03-31
002	2017-07-01
002	2017-07-01	SAI CHANTAVY	2020-01-06
002	2016-07-01
002	2016-07-01	SAI CHANTAVY	2019-02-01
002	2015-07-01
002	2014-07-01
002	2013-07-01	CECILE MORRIS
002	2012-07-01	SAI CHANTAVY
002	2011-07-01	SAI CHANTAVY
002	2010-07-01	SAI CHANTAVY
002	2009-07-01	SAI CHANTAVY

Plan Statistics for MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN

401k plan membership statisitcs for MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN

Measure Date Value
2021: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 239
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 119
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 107
Total of all active and inactive participants 2021-07-01 226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 226
Number of participants with account balances 2021-07-01 226
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 217
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 123
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 108
Total of all active and inactive participants 2020-07-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 231
Number of participants with account balances 2020-07-01 231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 192
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 119
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 86
Total of all active and inactive participants 2019-07-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 205
Number of participants with account balances 2019-07-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 169
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 116
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 76
Total of all active and inactive participants 2018-07-01 192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 192
Number of participants with account balances 2018-07-01 192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 169
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 108
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 61
Total of all active and inactive participants 2017-07-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 169
Number of participants with account balances 2017-07-01 169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 154
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 102
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 59
Total of all active and inactive participants 2016-07-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 161
Number of participants with account balances 2016-07-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 149
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 103
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 45
Total of all active and inactive participants 2015-07-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 148
Number of participants with account balances 2015-07-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 148
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 105
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 34
Total of all active and inactive participants 2014-07-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 139
Number of participants with account balances 2014-07-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 143
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 105
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 36
Total of all active and inactive participants 2013-07-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 141
Number of participants with account balances 2013-07-01 141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 138
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 109
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 25
Total of all active and inactive participants 2012-07-01 134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 134
Number of participants with account balances 2012-07-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 125
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 112
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 25
Total of all active and inactive participants 2011-07-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 137
Number of participants with account balances 2011-07-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 120
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 105
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 16
Total of all active and inactive participants 2010-07-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 121
Number of participants with account balances 2010-07-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 115
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 107
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 7
Total of all active and inactive participants 2009-07-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 114
Number of participants with account balances 2009-07-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2021: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	239
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	119
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	107
Total of all active and inactive participants	2021-07-01	226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	226
Number of participants with account balances	2021-07-01	226
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	217
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	123
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	108
Total of all active and inactive participants	2020-07-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	231
Number of participants with account balances	2020-07-01	231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	192
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	119
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	86
Total of all active and inactive participants	2019-07-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	205
Number of participants with account balances	2019-07-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	169
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	116
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	76
Total of all active and inactive participants	2018-07-01	192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	192
Number of participants with account balances	2018-07-01	192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	169
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	108
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	61
Total of all active and inactive participants	2017-07-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	169
Number of participants with account balances	2017-07-01	169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	154
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	102
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	59
Total of all active and inactive participants	2016-07-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	161
Number of participants with account balances	2016-07-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	149
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	103
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	45
Total of all active and inactive participants	2015-07-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	148
Number of participants with account balances	2015-07-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	148
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	105
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	34
Total of all active and inactive participants	2014-07-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	139
Number of participants with account balances	2014-07-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	143
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	105
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	36
Total of all active and inactive participants	2013-07-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	141
Number of participants with account balances	2013-07-01	141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	138
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	109
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	25
Total of all active and inactive participants	2012-07-01	134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	134
Number of participants with account balances	2012-07-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	125
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	112
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	25
Total of all active and inactive participants	2011-07-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	137
Number of participants with account balances	2011-07-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	120
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	105
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	16
Total of all active and inactive participants	2010-07-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	121
Number of participants with account balances	2010-07-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	115
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	107
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	7
Total of all active and inactive participants	2009-07-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	114
Number of participants with account balances	2009-07-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN

Measure	Date	Value
2022 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-151,124
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$1,382,012
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$1,372,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$530,729
Value of total assets at end of year	2022-06-30	$4,451,086
Value of total assets at beginning of year	2022-06-30	$5,984,222
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$9,526
Total interest from all sources	2022-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Assets. Real estate other than employer real property at end of year	2022-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2022-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-06-30	$0
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$650,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$340,656
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$14,474
Assets. Other investments not covered elsewhere at end of year	2022-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-06-30	$0
Assets. Loans (other than to participants) at end of year	2022-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-06-30	$0
Liabilities. Value of operating payables at end of year	2022-06-30	$0
Liabilities. Value of operating payables at beginning of year	2022-06-30	$0
Total non interest bearing cash at end of year	2022-06-30	$0
Total non interest bearing cash at beginning of year	2022-06-30	$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	2022-06-30	No
Value of net income/loss	2022-06-30	$-1,533,136
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$4,451,086
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$5,984,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Assets. partnership/joint venture interests at end of year	2022-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2022-06-30	$0
Investment advisory and management fees	2022-06-30	$9,526
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$0
Value of interest in pooled separate accounts at end of year	2022-06-30	$4,066,061
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$5,569,402
Value of interest in master investment trust accounts at end of year	2022-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2022-06-30	$0
Value of interest in common/collective trusts at end of year	2022-06-30	$0
Value of interest in common/collective trusts at beginning of year	2022-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$385,025
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$393,002
Asset value of US Government securities at end of year	2022-06-30	$0
Asset value of US Government securities at beginning of year	2022-06-30	$0
Net investment gain/loss from pooled separate accounts	2022-06-30	$-681,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Assets. Invements in employer securities at end of year	2022-06-30	$0
Assets. Invements in employer securities at beginning of year	2022-06-30	$0
Assets. Value of employer real property at end of year	2022-06-30	$0
Assets. Value of employer real property at beginning of year	2022-06-30	$0
Contributions received in cash from employer	2022-06-30	$190,073
Employer contributions (assets) at end of year	2022-06-30	$0
Employer contributions (assets) at beginning of year	2022-06-30	$7,344
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$1,372,486
Asset. Corporate debt instrument preferred debt at end of year	2022-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2022-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-06-30	$0
Did the plan have assets held for investment	2022-06-30	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	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Liabilities. Value of acquisition indebtedness at end of year	2022-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-06-30	$0
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	RKL LLP
Accountancy firm EIN	2022-06-30	232108173
2021 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$1,845,690
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$203,081
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$197,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$576,743
Value of total assets at end of year	2021-06-30	$5,984,222
Value of total assets at beginning of year	2021-06-30	$4,341,613
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$5,966
Total interest from all sources	2021-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Assets. Real estate other than employer real property at end of year	2021-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2021-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-06-30	$0
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$650,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$197,115
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$378,811
Participant contributions at end of year	2021-06-30	$0
Participant contributions at beginning of year	2021-06-30	$0
Participant contributions at end of year	2021-06-30	$14,474
Participant contributions at beginning of year	2021-06-30	$13,761
Assets. Other investments not covered elsewhere at end of year	2021-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-06-30	$0
Assets. Loans (other than to participants) at end of year	2021-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2021-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-06-30	$0
Administrative expenses (other) incurred	2021-06-30	$0
Liabilities. Value of operating payables at end of year	2021-06-30	$0
Liabilities. Value of operating payables at beginning of year	2021-06-30	$0
Total non interest bearing cash at end of year	2021-06-30	$0
Total non interest bearing cash at beginning of year	2021-06-30	$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	2021-06-30	No
Value of net income/loss	2021-06-30	$1,642,609
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$5,984,222
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$4,341,613
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Assets. partnership/joint venture interests at end of year	2021-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2021-06-30	$0
Investment advisory and management fees	2021-06-30	$5,966
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$0
Value of interest in pooled separate accounts at end of year	2021-06-30	$5,569,402
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$3,967,767
Value of interest in master investment trust accounts at end of year	2021-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2021-06-30	$0
Value of interest in common/collective trusts at end of year	2021-06-30	$0
Value of interest in common/collective trusts at beginning of year	2021-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$393,002
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$353,721
Asset value of US Government securities at end of year	2021-06-30	$0
Asset value of US Government securities at beginning of year	2021-06-30	$0
Net investment gain/loss from pooled separate accounts	2021-06-30	$1,268,947
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Assets. Invements in employer securities at end of year	2021-06-30	$0
Assets. Invements in employer securities at beginning of year	2021-06-30	$0
Assets. Value of employer real property at end of year	2021-06-30	$0
Assets. Value of employer real property at beginning of year	2021-06-30	$0
Contributions received in cash from employer	2021-06-30	$197,932
Employer contributions (assets) at end of year	2021-06-30	$7,344
Employer contributions (assets) at beginning of year	2021-06-30	$6,364
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$197,115
Asset. Corporate debt instrument preferred debt at end of year	2021-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2021-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2021-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-06-30	$0
Did the plan have assets held for investment	2021-06-30	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	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Liabilities. Value of acquisition indebtedness at end of year	2021-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-06-30	$0
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	RKL LLP
Accountancy firm EIN	2021-06-30	232108173
2020 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$642,144
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$194,615
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$189,294
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$534,046
Value of total assets at end of year	2020-06-30	$4,341,613
Value of total assets at beginning of year	2020-06-30	$3,894,084
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$5,321
Total interest from all sources	2020-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Assets. Real estate other than employer real property at end of year	2020-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-06-30	$0
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$650,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$366,756
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Participant contributions at end of year	2020-06-30	$13,761
Participant contributions at beginning of year	2020-06-30	$11,163
Assets. Other investments not covered elsewhere at end of year	2020-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$0
Assets. Loans (other than to participants) at end of year	2020-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$0
Liabilities. Value of operating payables at end of year	2020-06-30	$0
Liabilities. Value of operating payables at beginning of year	2020-06-30	$0
Total non interest bearing cash at end of year	2020-06-30	$0
Total non interest bearing cash at beginning of year	2020-06-30	$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	2020-06-30	No
Value of net income/loss	2020-06-30	$447,529
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$4,341,613
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$3,894,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Assets. partnership/joint venture interests at end of year	2020-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2020-06-30	$0
Investment advisory and management fees	2020-06-30	$5,321
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$0
Value of interest in pooled separate accounts at end of year	2020-06-30	$3,967,767
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$3,620,772
Value of interest in master investment trust accounts at end of year	2020-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2020-06-30	$0
Value of interest in common/collective trusts at end of year	2020-06-30	$0
Value of interest in common/collective trusts at beginning of year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2020-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$353,721
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$255,892
Asset value of US Government securities at end of year	2020-06-30	$0
Asset value of US Government securities at beginning of year	2020-06-30	$0
Net investment gain/loss from pooled separate accounts	2020-06-30	$108,098
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Assets. Invements in employer securities at end of year	2020-06-30	$0
Assets. Invements in employer securities at beginning of year	2020-06-30	$0
Assets. Value of employer real property at end of year	2020-06-30	$0
Assets. Value of employer real property at beginning of year	2020-06-30	$0
Contributions received in cash from employer	2020-06-30	$167,290
Employer contributions (assets) at end of year	2020-06-30	$6,364
Employer contributions (assets) at beginning of year	2020-06-30	$6,257
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$189,294
Asset. Corporate debt instrument preferred debt at end of year	2020-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2020-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2020-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-06-30	$0
Did the plan have assets held for investment	2020-06-30	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	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Liabilities. Value of acquisition indebtedness at end of year	2020-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	RKL LLP
Accountancy firm EIN	2020-06-30	232108173
2019 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$625,422
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$93,737
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$89,019
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$424,088
Value of total assets at end of year	2019-06-30	$3,894,084
Value of total assets at beginning of year	2019-06-30	$3,362,399
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$4,718
Total interest from all sources	2019-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Assets. Real estate other than employer real property at end of year	2019-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2019-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2019-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-06-30	$0
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$650,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$267,991
Participant contributions at end of year	2019-06-30	$0
Participant contributions at beginning of year	2019-06-30	$0
Participant contributions at end of year	2019-06-30	$11,163
Participant contributions at beginning of year	2019-06-30	$9,792
Assets. Other investments not covered elsewhere at end of year	2019-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-06-30	$0
Assets. Loans (other than to participants) at end of year	2019-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2019-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-06-30	$0
Liabilities. Value of operating payables at end of year	2019-06-30	$0
Liabilities. Value of operating payables at beginning of year	2019-06-30	$0
Total non interest bearing cash at end of year	2019-06-30	$0
Total non interest bearing cash at beginning of year	2019-06-30	$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	2019-06-30	No
Value of net income/loss	2019-06-30	$531,685
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$3,894,084
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$3,362,399
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Assets. partnership/joint venture interests at end of year	2019-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2019-06-30	$0
Investment advisory and management fees	2019-06-30	$4,718
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$0
Value of interest in pooled separate accounts at end of year	2019-06-30	$3,620,772
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$3,126,742
Value of interest in master investment trust accounts at end of year	2019-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2019-06-30	$0
Value of interest in common/collective trusts at end of year	2019-06-30	$0
Value of interest in common/collective trusts at beginning of year	2019-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2019-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$255,892
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$220,554
Asset value of US Government securities at end of year	2019-06-30	$0
Asset value of US Government securities at beginning of year	2019-06-30	$0
Net investment gain/loss from pooled separate accounts	2019-06-30	$201,334
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Assets. Invements in employer securities at end of year	2019-06-30	$0
Assets. Invements in employer securities at beginning of year	2019-06-30	$0
Assets. Value of employer real property at end of year	2019-06-30	$0
Assets. Value of employer real property at beginning of year	2019-06-30	$0
Contributions received in cash from employer	2019-06-30	$156,097
Employer contributions (assets) at end of year	2019-06-30	$6,257
Employer contributions (assets) at beginning of year	2019-06-30	$5,311
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$89,019
Asset. Corporate debt instrument preferred debt at end of year	2019-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2019-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2019-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2019-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-06-30	$0
Did the plan have assets held for investment	2019-06-30	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	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Liabilities. Value of acquisition indebtedness at end of year	2019-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	RKL LLP
Accountancy firm EIN	2019-06-30	232108173
2018 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-06-30	$0
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total transfer of assets to this plan	2018-06-30	$0
Total transfer of assets from this plan	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Expenses. Interest paid	2018-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$665,521
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$650,230
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$644,643
Expenses. Certain deemed distributions of participant loans	2018-06-30	$0
Value of total corrective distributions	2018-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$401,971
Value of total assets at end of year	2018-06-30	$3,362,399
Value of total assets at beginning of year	2018-06-30	$3,347,108
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$5,587
Total income from rents	2018-06-30	$0
Total interest from all sources	2018-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$0
Assets. Real estate other than employer real property at end of year	2018-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2018-06-30	$0
Administrative expenses professional fees incurred	2018-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-06-30	$0
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$247,967
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$0
Participant contributions at end of year	2018-06-30	$9,792
Participant contributions at beginning of year	2018-06-30	$8,801
Assets. Other investments not covered elsewhere at end of year	2018-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$0
Assets. Loans (other than to participants) at end of year	2018-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$0
Administrative expenses (other) incurred	2018-06-30	$0
Liabilities. Value of operating payables at end of year	2018-06-30	$0
Liabilities. Value of operating payables at beginning of year	2018-06-30	$0
Total non interest bearing cash at end of year	2018-06-30	$0
Total non interest bearing cash at beginning of year	2018-06-30	$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	2018-06-30	No
Income. Non cash contributions	2018-06-30	$0
Value of net income/loss	2018-06-30	$15,291
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$3,362,399
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$3,347,108
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Assets. partnership/joint venture interests at end of year	2018-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2018-06-30	$0
Investment advisory and management fees	2018-06-30	$5,587
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$0
Value of interest in pooled separate accounts at end of year	2018-06-30	$3,126,742
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$3,120,435
Interest on participant loans	2018-06-30	$0
Income. Interest from loans (other than to participants)	2018-06-30	$0
Interest earned on other investments	2018-06-30	$0
Income. Interest from US Government securities	2018-06-30	$0
Income. Interest from corporate debt instruments	2018-06-30	$0
Value of interest in master investment trust accounts at end of year	2018-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2018-06-30	$0
Value of interest in common/collective trusts at end of year	2018-06-30	$0
Value of interest in common/collective trusts at beginning of year	2018-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2018-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$220,554
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$213,052
Expenses. Payments to insurance carriers foe the provision of benefits	2018-06-30	$0
Asset value of US Government securities at end of year	2018-06-30	$0
Asset value of US Government securities at beginning of year	2018-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$0
Net investment gain/loss from pooled separate accounts	2018-06-30	$263,550
Net investment gain or loss from common/collective trusts	2018-06-30	$0
Net gain/loss from 103.12 investment entities	2018-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Assets. Invements in employer securities at end of year	2018-06-30	$0
Assets. Invements in employer securities at beginning of year	2018-06-30	$0
Assets. Value of employer real property at end of year	2018-06-30	$0
Assets. Value of employer real property at beginning of year	2018-06-30	$0
Contributions received in cash from employer	2018-06-30	$154,004
Employer contributions (assets) at end of year	2018-06-30	$5,311
Employer contributions (assets) at beginning of year	2018-06-30	$4,820
Income. Dividends from preferred stock	2018-06-30	$0
Income. Dividends from common stock	2018-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$644,643
Asset. Corporate debt instrument preferred debt at end of year	2018-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-06-30	$0
Contract administrator fees	2018-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2018-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2018-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2018-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-06-30	$0
Did the plan have assets held for investment	2018-06-30	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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Aggregate proceeds on sale of assets	2018-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2018-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2018-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	RKL, LLP
Accountancy firm EIN	2018-06-30	232108173
2017 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-06-30	$0
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total transfer of assets to this plan	2017-06-30	$0
Total transfer of assets from this plan	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$1,043
Expenses. Interest paid	2017-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$917,325
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$76,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$72,189
Expenses. Certain deemed distributions of participant loans	2017-06-30	$0
Value of total corrective distributions	2017-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$597,092
Value of total assets at end of year	2017-06-30	$3,363,867
Value of total assets at beginning of year	2017-06-30	$2,524,157
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$4,383
Total income from rents	2017-06-30	$0
Total interest from all sources	2017-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$0
Assets. Real estate other than employer real property at end of year	2017-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2017-06-30	$0
Administrative expenses professional fees incurred	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-06-30	$0
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$272,093
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$0
Participant contributions at end of year	2017-06-30	$8,837
Participant contributions at beginning of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$173,095
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-06-30	$0
Assets. Loans (other than to participants) at end of year	2017-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$1,043
Other income not declared elsewhere	2017-06-30	$6
Administrative expenses (other) incurred	2017-06-30	$0
Liabilities. Value of operating payables at end of year	2017-06-30	$0
Liabilities. Value of operating payables at beginning of year	2017-06-30	$0
Total non interest bearing cash at end of year	2017-06-30	$0
Total non interest bearing cash at beginning of year	2017-06-30	$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	2017-06-30	No
Income. Non cash contributions	2017-06-30	$0
Value of net income/loss	2017-06-30	$840,753
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$3,363,867
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$2,523,114
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Assets. partnership/joint venture interests at end of year	2017-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2017-06-30	$0
Investment advisory and management fees	2017-06-30	$4,383
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$0
Value of interest in pooled separate accounts at end of year	2017-06-30	$3,120,434
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$2,381,901
Interest on participant loans	2017-06-30	$0
Income. Interest from loans (other than to participants)	2017-06-30	$0
Interest earned on other investments	2017-06-30	$0
Income. Interest from US Government securities	2017-06-30	$0
Income. Interest from corporate debt instruments	2017-06-30	$0
Value of interest in master investment trust accounts at end of year	2017-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2017-06-30	$0
Value of interest in common/collective trusts at end of year	2017-06-30	$0
Value of interest in common/collective trusts at beginning of year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2017-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$213,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$128,227
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$0
Asset value of US Government securities at end of year	2017-06-30	$0
Asset value of US Government securities at beginning of year	2017-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$320,227
Net investment gain/loss from pooled separate accounts	2017-06-30	$320,863
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Assets. Invements in employer securities at end of year	2017-06-30	$0
Assets. Invements in employer securities at beginning of year	2017-06-30	$0
Assets. Value of employer real property at end of year	2017-06-30	$0
Assets. Value of employer real property at beginning of year	2017-06-30	$0
Contributions received in cash from employer	2017-06-30	$151,904
Employer contributions (assets) at end of year	2017-06-30	$21,544
Employer contributions (assets) at beginning of year	2017-06-30	$14,029
Income. Dividends from preferred stock	2017-06-30	$0
Income. Dividends from common stock	2017-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$72,189
Asset. Corporate debt instrument preferred debt at end of year	2017-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-06-30	$0
Contract administrator fees	2017-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2017-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-06-30	$0
Did the plan have assets held for investment	2017-06-30	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	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Aggregate proceeds on sale of assets	2017-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2017-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2017-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2017-06-30	274573546
2016 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$1,043
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$422,526
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$75,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$72,089
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$402,703
Value of total assets at end of year	2016-06-30	$2,524,157
Value of total assets at beginning of year	2016-06-30	$2,175,958
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$3,281
Total interest from all sources	2016-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Assets. Real estate other than employer real property at end of year	2016-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2016-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-06-30	$0
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$248,095
Participant contributions at end of year	2016-06-30	$0
Participant contributions at beginning of year	2016-06-30	$0
Participant contributions at end of year	2016-06-30	$0
Participant contributions at beginning of year	2016-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2016-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-06-30	$0
Assets. Loans (other than to participants) at end of year	2016-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2016-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-06-30	$1,043
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-06-30	$0
Other income not declared elsewhere	2016-06-30	$0
Liabilities. Value of operating payables at end of year	2016-06-30	$0
Liabilities. Value of operating payables at beginning of year	2016-06-30	$0
Total non interest bearing cash at end of year	2016-06-30	$0
Total non interest bearing cash at beginning of year	2016-06-30	$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	2016-06-30	No
Value of net income/loss	2016-06-30	$347,156
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$2,523,114
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,175,958
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Assets. partnership/joint venture interests at end of year	2016-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2016-06-30	$0
Investment advisory and management fees	2016-06-30	$3,281
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$0
Value of interest in pooled separate accounts at end of year	2016-06-30	$2,381,901
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$2,081,886
Value of interest in master investment trust accounts at end of year	2016-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2016-06-30	$0
Value of interest in common/collective trusts at end of year	2016-06-30	$0
Value of interest in common/collective trusts at beginning of year	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$128,227
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$87,592
Asset value of US Government securities at end of year	2016-06-30	$0
Asset value of US Government securities at beginning of year	2016-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$0
Net investment gain/loss from pooled separate accounts	2016-06-30	$19,823
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Assets. Invements in employer securities at end of year	2016-06-30	$0
Assets. Invements in employer securities at beginning of year	2016-06-30	$0
Assets. Value of employer real property at end of year	2016-06-30	$0
Assets. Value of employer real property at beginning of year	2016-06-30	$0
Contributions received in cash from employer	2016-06-30	$154,608
Employer contributions (assets) at end of year	2016-06-30	$14,029
Employer contributions (assets) at beginning of year	2016-06-30	$6,480
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$72,089
Asset. Corporate debt instrument preferred debt at end of year	2016-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2016-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2016-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-06-30	$0
Did the plan have assets held for investment	2016-06-30	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	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Liabilities. Value of acquisition indebtedness at end of year	2016-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2016-06-30	274573546
2015 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-06-30	$0
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total transfer of assets to this plan	2015-06-30	$0
Total transfer of assets from this plan	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Expenses. Interest paid	2015-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$460,752
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$209,352
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$205,212
Expenses. Certain deemed distributions of participant loans	2015-06-30	$0
Value of total corrective distributions	2015-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$404,292
Value of total assets at end of year	2015-06-30	$2,175,958
Value of total assets at beginning of year	2015-06-30	$1,924,558
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$4,140
Total income from rents	2015-06-30	$0
Total interest from all sources	2015-06-30	$2,491
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$0
Assets. Real estate other than employer real property at end of year	2015-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2015-06-30	$0
Administrative expenses professional fees incurred	2015-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-06-30	$0
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$253,653
Participant contributions at end of year	2015-06-30	$0
Participant contributions at beginning of year	2015-06-30	$0
Participant contributions at end of year	2015-06-30	$0
Participant contributions at beginning of year	2015-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2015-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-06-30	$0
Assets. Loans (other than to participants) at end of year	2015-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2015-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-30	$0
Other income not declared elsewhere	2015-06-30	$0
Administrative expenses (other) incurred	2015-06-30	$0
Liabilities. Value of operating payables at end of year	2015-06-30	$0
Liabilities. Value of operating payables at beginning of year	2015-06-30	$0
Total non interest bearing cash at end of year	2015-06-30	$0
Total non interest bearing cash at beginning of year	2015-06-30	$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	2015-06-30	No
Income. Non cash contributions	2015-06-30	$0
Value of net income/loss	2015-06-30	$251,400
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,175,958
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$1,924,558
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Assets. partnership/joint venture interests at end of year	2015-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2015-06-30	$0
Investment advisory and management fees	2015-06-30	$4,140
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$0
Value of interest in pooled separate accounts at end of year	2015-06-30	$2,081,886
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$1,583,645
Interest on participant loans	2015-06-30	$0
Income. Interest from loans (other than to participants)	2015-06-30	$0
Interest earned on other investments	2015-06-30	$0
Income. Interest from US Government securities	2015-06-30	$0
Income. Interest from corporate debt instruments	2015-06-30	$0
Value of interest in master investment trust accounts at end of year	2015-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2015-06-30	$0
Value of interest in common/collective trusts at end of year	2015-06-30	$0
Value of interest in common/collective trusts at beginning of year	2015-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$2,491
Assets. Value of investments in 103.12 investment entities at end of year	2015-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$87,592
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$336,837
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$0
Asset value of US Government securities at end of year	2015-06-30	$0
Asset value of US Government securities at beginning of year	2015-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$53,969
Net investment gain/loss from pooled separate accounts	2015-06-30	$0
Net investment gain or loss from common/collective trusts	2015-06-30	$0
Net gain/loss from 103.12 investment entities	2015-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Assets. Invements in employer securities at end of year	2015-06-30	$0
Assets. Invements in employer securities at beginning of year	2015-06-30	$0
Assets. Value of employer real property at end of year	2015-06-30	$0
Assets. Value of employer real property at beginning of year	2015-06-30	$0
Contributions received in cash from employer	2015-06-30	$150,639
Employer contributions (assets) at end of year	2015-06-30	$6,480
Employer contributions (assets) at beginning of year	2015-06-30	$4,076
Income. Dividends from preferred stock	2015-06-30	$0
Income. Dividends from common stock	2015-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$205,212
Asset. Corporate debt instrument preferred debt at end of year	2015-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-06-30	$0
Contract administrator fees	2015-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2015-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2015-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-06-30	$0
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Aggregate proceeds on sale of assets	2015-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2015-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2015-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2015-06-30	274573546
2014 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-06-30	$0
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Expenses. Interest paid	2014-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$598,698
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$97,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$91,773
Expenses. Certain deemed distributions of participant loans	2014-06-30	$0
Value of total corrective distributions	2014-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$387,904
Value of total assets at end of year	2014-06-30	$1,924,558
Value of total assets at beginning of year	2014-06-30	$1,423,146
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$5,513
Total income from rents	2014-06-30	$0
Total interest from all sources	2014-06-30	$3,965
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$0
Assets. Real estate other than employer real property at end of year	2014-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2014-06-30	$0
Administrative expenses professional fees incurred	2014-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-06-30	$0
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$236,411
Participant contributions at end of year	2014-06-30	$0
Participant contributions at beginning of year	2014-06-30	$0
Participant contributions at end of year	2014-06-30	$0
Participant contributions at beginning of year	2014-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2014-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-06-30	$0
Assets. Loans (other than to participants) at end of year	2014-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2014-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-06-30	$0
Other income not declared elsewhere	2014-06-30	$14
Administrative expenses (other) incurred	2014-06-30	$0
Liabilities. Value of operating payables at end of year	2014-06-30	$0
Liabilities. Value of operating payables at beginning of year	2014-06-30	$0
Total non interest bearing cash at end of year	2014-06-30	$0
Total non interest bearing cash at beginning of year	2014-06-30	$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	2014-06-30	No
Income. Non cash contributions	2014-06-30	$0
Value of net income/loss	2014-06-30	$501,412
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$1,924,558
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$1,423,146
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Assets. partnership/joint venture interests at end of year	2014-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2014-06-30	$0
Investment advisory and management fees	2014-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$0
Value of interest in pooled separate accounts at end of year	2014-06-30	$1,583,645
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$1,158,491
Interest on participant loans	2014-06-30	$0
Income. Interest from loans (other than to participants)	2014-06-30	$0
Interest earned on other investments	2014-06-30	$0
Income. Interest from US Government securities	2014-06-30	$0
Income. Interest from corporate debt instruments	2014-06-30	$0
Value of interest in master investment trust accounts at end of year	2014-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2014-06-30	$0
Value of interest in common/collective trusts at end of year	2014-06-30	$0
Value of interest in common/collective trusts at beginning of year	2014-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$3,965
Assets. Value of investments in 103.12 investment entities at end of year	2014-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2014-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$336,837
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$262,274
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$0
Asset value of US Government securities at end of year	2014-06-30	$0
Asset value of US Government securities at beginning of year	2014-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$206,815
Net investment gain/loss from pooled separate accounts	2014-06-30	$0
Net investment gain or loss from common/collective trusts	2014-06-30	$0
Net gain/loss from 103.12 investment entities	2014-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Assets. Invements in employer securities at end of year	2014-06-30	$0
Assets. Invements in employer securities at beginning of year	2014-06-30	$0
Assets. Value of employer real property at end of year	2014-06-30	$0
Assets. Value of employer real property at beginning of year	2014-06-30	$0
Contributions received in cash from employer	2014-06-30	$151,493
Employer contributions (assets) at end of year	2014-06-30	$4,076
Employer contributions (assets) at beginning of year	2014-06-30	$2,381
Income. Dividends from preferred stock	2014-06-30	$0
Income. Dividends from common stock	2014-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$91,773
Asset. Corporate debt instrument preferred debt at end of year	2014-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-06-30	$0
Contract administrator fees	2014-06-30	$5,513
Assets. Corporate common stocks other than exployer securities at end of year	2014-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2014-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-06-30	$0
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Aggregate proceeds on sale of assets	2014-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2014-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2014-06-30	274573546
2013 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-06-30	$0
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Expenses. Interest paid	2013-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$487,577
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$49,773
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$44,820
Expenses. Certain deemed distributions of participant loans	2013-06-30	$0
Value of total corrective distributions	2013-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$356,891
Value of total assets at end of year	2013-06-30	$1,423,146
Value of total assets at beginning of year	2013-06-30	$985,342
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$4,953
Total income from rents	2013-06-30	$0
Total interest from all sources	2013-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$0
Assets. Real estate other than employer real property at end of year	2013-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2013-06-30	$0
Administrative expenses professional fees incurred	2013-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-06-30	$0
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$213,488
Participant contributions at end of year	2013-06-30	$0
Participant contributions at beginning of year	2013-06-30	$0
Participant contributions at end of year	2013-06-30	$0
Participant contributions at beginning of year	2013-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2013-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$0
Assets. Loans (other than to participants) at end of year	2013-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2013-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$0
Other income not declared elsewhere	2013-06-30	$0
Liabilities. Value of operating payables at end of year	2013-06-30	$0
Liabilities. Value of operating payables at beginning of year	2013-06-30	$0
Total non interest bearing cash at end of year	2013-06-30	$0
Total non interest bearing cash at beginning of year	2013-06-30	$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	2013-06-30	No
Income. Non cash contributions	2013-06-30	$0
Value of net income/loss	2013-06-30	$437,804
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$1,423,146
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$985,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Assets. partnership/joint venture interests at end of year	2013-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2013-06-30	$0
Investment advisory and management fees	2013-06-30	$4,953
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$0
Value of interest in pooled separate accounts at end of year	2013-06-30	$1,158,491
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$802,289
Interest on participant loans	2013-06-30	$0
Income. Interest from loans (other than to participants)	2013-06-30	$0
Interest earned on other investments	2013-06-30	$0
Income. Interest from US Government securities	2013-06-30	$0
Income. Interest from corporate debt instruments	2013-06-30	$0
Value of interest in master investment trust accounts at end of year	2013-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2013-06-30	$0
Value of interest in common/collective trusts at end of year	2013-06-30	$0
Value of interest in common/collective trusts at beginning of year	2013-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$262,274
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$183,053
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$0
Asset value of US Government securities at end of year	2013-06-30	$0
Asset value of US Government securities at beginning of year	2013-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$130,686
Net investment gain/loss from pooled separate accounts	2013-06-30	$0
Net investment gain or loss from common/collective trusts	2013-06-30	$0
Net gain/loss from 103.12 investment entities	2013-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Assets. Invements in employer securities at end of year	2013-06-30	$0
Assets. Invements in employer securities at beginning of year	2013-06-30	$0
Assets. Value of employer real property at end of year	2013-06-30	$0
Assets. Value of employer real property at beginning of year	2013-06-30	$0
Contributions received in cash from employer	2013-06-30	$143,403
Employer contributions (assets) at end of year	2013-06-30	$2,381
Employer contributions (assets) at beginning of year	2013-06-30	$0
Income. Dividends from preferred stock	2013-06-30	$0
Income. Dividends from common stock	2013-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$44,820
Asset. Corporate debt instrument preferred debt at end of year	2013-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-06-30	$0
Contract administrator fees	2013-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2013-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2013-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-06-30	$0
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Aggregate proceeds on sale of assets	2013-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2013-06-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2013-06-30	274573546
2012 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$342,257
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$47,754
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$44,658
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$349,743
Value of total assets at end of year	2012-06-30	$985,342
Value of total assets at beginning of year	2012-06-30	$690,839
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$3,096
Total interest from all sources	2012-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$220,910
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$294,503
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$985,342
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$690,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Investment advisory and management fees	2012-06-30	$3,096
Value of interest in pooled separate accounts at end of year	2012-06-30	$802,289
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$559,799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$183,053
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$131,040
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-7,486
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$128,833
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$44,658
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2012-06-30	274573546
2011 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$409,656
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$29,831
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$27,953
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$340,987
Value of total assets at end of year	2011-06-30	$690,839
Value of total assets at beginning of year	2011-06-30	$311,014
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$1,878
Total interest from all sources	2011-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$215,325
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$379,825
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$690,839
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$311,014
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Investment advisory and management fees	2011-06-30	$1,878
Value of interest in pooled separate accounts at end of year	2011-06-30	$559,799
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$222,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$131,040
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$86,390
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$68,669
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$125,662
Employer contributions (assets) at end of year	2011-06-30	$0
Employer contributions (assets) at beginning of year	2011-06-30	$2,364
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$27,953
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	STILLWAGGON & MCGILL, LLC
Accountancy firm EIN	2011-06-30	274573546
2010 : MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN

2021: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: MAUNALANI NURSING AND REHABILITATION CENTER 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	First time form 5500 has been submitted	Yes
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	237
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,737
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
Amount paid for insurance broker fees	2737
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	231
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $11,601
Total amount of fees paid to insurance company	USD $2,595
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 $11,601
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	205
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $10,153
Total amount of fees paid to insurance company	USD $2,029
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 $10,153
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	192
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $8,791
Total amount of fees paid to insurance company	USD $1,761
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,791
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	167
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $8,669
Total amount of fees paid to insurance company	USD $1,746
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	148
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $5,701
Total amount of fees paid to insurance company	USD $1,377
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,701
Insurance broker organization code?	3
Amount paid for insurance broker fees	1377
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker name	PENSION SERVICES CORPORATION

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	139
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $4,512
Total amount of fees paid to insurance company	USD $1,491
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,512
Insurance broker organization code?	3
Amount paid for insurance broker fees	1491
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker name	PENSION SERVICES CORPORATION

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

942058-01

Policy instance

Insurance contract or identification number	942058-01
Number of Individuals Covered	0
Insurance policy start date	2014-07-01
Insurance policy end date	2015-02-25
Total amount of commissions paid to insurance broker	USD $530
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $530
Insurance broker organization code?	3
Insurance broker name	USB FINANCIAL SERVICES, INC.

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805001-000

Policy instance

Insurance contract or identification number	805001-000
Number of Individuals Covered	141
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $950
Total amount of fees paid to insurance company	USD $2,362
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2362
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $950
Insurance broker name	USB FINANCIAL SERVICES INSURANCE AG

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

942058-01

Policy instance

Insurance contract or identification number	942058-01
Number of Individuals Covered	98
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $2,895
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $2,895
Insurance broker organization code?	3
Insurance broker name	USB FINANCIAL SERVICES, INC.

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

942058-01

Policy instance

Insurance contract or identification number	942058-01
Number of Individuals Covered	132
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $6,595
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $6,595
Insurance broker organization code?	3
Insurance broker name	USB FINANCIAL SERVICES, INC.

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

942058-01

Policy instance

Insurance contract or identification number	942058-01
Number of Individuals Covered	126
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

942058-01

Policy instance

Insurance contract or identification number	942058-01
Number of Individuals Covered	113
Insurance policy start date	2010-06-30
Insurance policy end date	2011-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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Company Name:	MAUNALANI NURSING AND REHABILITATION CENTER
Employer identification number (EIN):	990249327
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities