Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 10000077 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| F990_P03_S00_L03 | Form 990, Part III, Line 3 | The William B. Kessler Memorial Hospital closed operations as a full service hospital on March 12, 2009. On March 13, 2009 the AtlantiCare Regional Medical Center hospital system lease space from The William B. Kessler Memorial Hospital to provide emergency room, radiology and lab services in Hammonton and the surrouding communities. A complete closure of the Hospital and all services is expected in 2011. |
| F990_P04_S00_L20a | Form 990, Part IV, Line 20a | Hospital closed operations March 12, 2009. No longer directly performing hospital activities. Starting March 13, 2009 Kessler leased space to the Atlanticare Regional Medical Center to perform emergency room, radiology and lab services for the Hammonton community and surounding area. |
| F990_P06_S0A_L08a | Form 990, Part VI, Section A, Line 8a | Hospital shut down in March 2009 and has had no formal meetings of the board of directors in 2010. Decisions regarding the closure of the Hospital are made by a 4 person Executive Committee of the board with periodic updates made via conference calls to board members. |
| F990_P06_S0A_L08b | Form 990, Part VI, Section A, Line 8b | Hospital shut down in March 2009 and had no formal meetings of the board of directors in 2010. Decisions regarding the closure of the Hospital are made by a 4 person Executive Committee of the board with periodic updates made via conference calls made with the board. No formal board minutes kept. |
| F990_P06_S0B_L11a | Form 990, Part VI, Section B, Line 11a | Copy of Form 990 Draft distributed and comments, if any, requested from Board |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The Form 990 is filed yearly and becomes part of the public record |
| F990_P08_S00_L11a | Form 990, Part VIII, Line 11a 11b 11c | Lease payments from Atlanticare Regional Medical Center for operation of emergency room, lab and radiology services from KMH facilities. Leasing is substantially related to the charitable mission of KMH in providing healthcare services to Hammonton community |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | Miscellaneous rounding adjustment of =$2 |
| Software ID: | 10000077 |
| Software Version: | v1.00 |