2023 Form 5500 filing — Clove Lakes Health Care And Rehabilitation Center, Inc. 401(K) Plan
Plain-English filing summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20241015124958NAL0028477217003) for Clove Lakes Health Care And Rehabilitation Center, Inc. 401(K) Plan, reported by Clove Lakes Snf Operations LLC under EIN 13-3954527 and plan number 002. It reports 225 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$7.7MReported net assets$7,670,515
Participants225
Provider compensationNone reported
Schedules filedSchedule HLoaded schedules
- EFAST2 acknowledgement
- 20241015124958NAL0028477217003
- Plan sponsor
- Clove Lakes Snf Operations LLC
- EIN
- 13-3954527
- Plan number
- 002
- Location
- Staten Island, NY
- Received date
- not reported in the loaded dataset
How to read this filing
- This is a single annual Form 5500 filing, identified by its EFAST2 acknowledgement id.
- Schedule chips (Sch H / I / C) show which schedules this filing includes.
- Net assets = total assets minus total liabilities (Schedule H/I).
- Fields a filing did not report are labeled not reported in the loaded dataset — never estimated.
- For the plan's full history, open the plan profile.
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$7.7M total assets
Net assets$7.7MLiabilities—
Full reported line items
- Total assets (EOY)
- $7,670,515
- Net assets (EOY)
- $7,670,515
- Employer contributions
- $107,165
- Participant contributions
- $251,124
- Total income / additions
- $1,181,659
- Benefits paid
- $982,770
- Administrative expenses
- $8,288
- Total expenses
- $991,058
- Net increase / (decrease)
- $190,601
Frequently asked questions
- What does EFAST2 acknowledgement 20241015124958NAL0028477217003 cover?
- It is the 2023 Form 5500 filing for Clove Lakes Health Care And Rehabilitation Center, Inc. 401(K) Plan, reported by Clove Lakes Snf Operations LLC (EIN 13-3954527).
- Which Form 5500 schedules are attached to this 2023 filing?
- Attached schedules in the loaded dataset include Schedule H (large plan financials).