xt72jm23ck8t https://exploreuk.uky.edu/dips/xt72jm23ck8t/data/mets.xml The Frontier Nursing Service, Inc. 1997 bulletins  English The Frontier Nursing Service, Inc. Contact the Special Collections Research Center for information regarding rights and use of this collection. Frontier Nursing Service Quarterly Bulletins Frontier Nursing Service, Vol. 73, No. 1, Summer Issue/September 1997 text Frontier Nursing Service, Vol. 73, No. 1, Summer Issue/September 1997 1997 2014 true xt72jm23ck8t section xt72jm23ck8t W
* Volume 73 Number 1 Summer Issue/September l997    
~ Celebrating 72 Years of Service
A A m ‘ ' `Y ;v;....i, ;.¤·‘.?f > hA  I V:   H —  
R   {esl   iiii **  `    rr-i e .L-Q. M ee.  
+=~  »       W I r ,r·~ 1   *   r p
,;».   I r V ·     _   .;:_;_y, r V .,-2
      .,,e ... ` PV      V, I-
  ‘   A . \
‘ "   ie r ,
.. »_‘ I H l
Yesterday Q_. .‘   _ my _F;;_;;
gg;   _ _ j,-rf I   qi
pwegw 4,. ·   Q 1i§ ·  
`*"`?=——“$~···'·¢   I ·—~~    
{ Mm     are cusp students?
" \ ~ BRECK\NR\DG& ‘—
, . rs ra}
r ·x‘ ` ··j7· E M}  
M **3 F * ‘ · e
4       .7 J W
. vw ‘ ·
 ·;  Today
"  V‘?’ s;- '-     V 
 ‘ji:;__  a  •  
xr   _  _   _

US ISSN 0016-2116
Table of Contents ~
Introduction to the FNS - Deanna Severance 1 g
Wendover News — Jeremy T Bush 3
FSMFN/CNEP News - Susan Stone 7
CNEP - Community Lessons — Martha Redpath 9
Courier Program News - Karen Thomisee 1 1
Seventy—Second Annual Report - Potter & Company 15
Report of Operations 29
Miscellaneous 34
In Memoriam 38
Cover: Nurses on horseback, FNS jeep, FSMFN Class of 1975,
Mary Breckinridge Hospital, FNS Tracker and CNEP map (loca-
tion of CNEP graduates). Photos taken by FNS stajf
Frontier Nursing Service Quarterly Bulletin
Published at the end of each quarter by the Frontier Nursing Service, Inc.
Wendover, Kentucky 41775
Subscription Price $5.00 a Year for Donors
Subscription Price $15.00 a Year for Institutions
Second-class postage paid at Wendover, KY 41775 and at additional mailing ·i  
offices. POSTMASTER: Send address changes to FNS, Wendover, KY 41775. 1
Copyright FNS/Inc. 1997 All Rights Reserved t G

, The Frontier Nursing Service
U you have never been introduced to the Frontier
‘ Nursing Service we would like to take this opportunity to brief
you on the history and the on-going work of the Service. We
encourage you to share this Bulletin with a friend.
Born in 1881 into a prominent American family, Mary  
Breckinridge spent her early years in many parts of the world- l
Russia, France, Switzerland and the British Isles. After the  
death of her two children, she abandoned the homebound life 1
expected of women of her class to devote herself to the service l
of others, particularly children. 1
Mrs. Breckinridge established the Frontier Nursing A
Service (FNS) in Leslie County, Kentucky in 1925, then one of I
the poorest and most inaccessible areas in the United States.
Mrs. Breckinridge introduced the first nurse-midwives in this
country. Riding their horses up mountains and across streams
in blizzard, fog or flood, the FNS nurses brought modern .
V healthcare to families throughout an area of 700 square miles. ,
Until her death in 1965, Mary Breckinridge was the  
driving force behind the work of the Service whose influence  
today extends far beyond eastern Kentucky. Through the Fron-
  tier School of Midwifery and Family Nursing hundreds of
1 nurses have been trained and this important concept of family
_ healthcare has been carried throughout the world. V
Today the FNS is organized as a parent holding com-
pany for Mary Breckinridge Healthcare Inc., home health
agency, four outpost clinics, one primary care clinic in the  
* V hospital, Kate Ireland Women's Healthcare clinic and for the
_   Frontier School of Midwifery and Family Nursing — the largest
    midwifery program in the United States. I
  i Remarkably, the purpose and philosophy of the FNS
  . has remained constant since 1925. —Deanna Severance, CEO

 ` 7
`éJl"‘ ,    " " ‘ ’ ‘*’ —  `Y  ‘
` é¤   /,1%,    _ if   .·’  Yjy ,    XIV •'
    F     »  4*  — X  ff <7¤-L F2"     =
L   ';: ‘  -r‘ €>'  L,.   ` " "    · I- - 4 _’__-‘   ` _?   _- W J ‘ ~ ;C -·-_,  _
’ ~`·=`     ```` —   i ·     J        ·
    · e,   J .Q*¢i€*‘“.· · FQ:    ·4. j?  ‘    
' " · ‘ I'.   ;¥?H`}Aria?· "i*¥"”`é':‘L:·¥   `-   f
ey `Y:   gf; /.2. " H §~*  .]:*5;  
j _ _ `_-xi ,*1:;;- ._ “ .,_ . _/ =;_‘   ;J$~·;g-L  hl · ‘
  E ? --··‘‘   '""   ·    I-   !
 ir, sg€·1 L _  _ ‘   , .*;·_§;;§--we  ’;j?'
,5 , . · .:1;  ·· · :·. r   3,.     4--;;*. ···.   . ·_
 V   *·'*’  »,»». .  ?I"‘$€!  ` fe'?  ·· 
    · {_ _ {N13?  I 'ij   ·. gg ·      
;:_':'»· , M . ,`_A» - -_ N  w UE; ‘   · \. _ WE   ·__‘*._y£2"{ .» 'Z { ..-. -.1%
S   w m I -»~¤=—   . ·· -» g.  ¤;¢¢L·.;:.%¤. s· ·¢·=·. ·— _
"' * ·?`:J,:"’1·';`F   ‘ ..··~~· ,. .. _, ‘  ‘?Zf·"Z "$¢.  ,>S` .
   ~‘él%gJ§%;s· ’ é-gm,.  - >~  "·‘ ‘rj;,   · . ·;-/' ‘£` · .
     ° ‘  A ·   ‘ ·"'°F$2;`;&”3?#{ wlé ll '
   ~- ·5";;¤;,}·-j;.QS _ J  - J-`»;.‘“ ~"` _·._:— I, P ·
 ¢·?~:» %;;>i { i    si /-»‘¥*’ -~» I
  ‘:* €%e ’ ,4 L. ~ ·¢*  ,, fipa -·
The Big House - Home 0f Mary Breckinridge
    I I ’¤  vv-F    I -   F I  >
`   i¥*·é¤·.g I · A   X ,__,_   ~ ·—.. . .,»~    
 *—··»  "`Z?"F¥f??Tig?i     1 "     /'“  
"`·  ‘ · f " ? .        ‘. _,   ~· ‘, , T:"¤W¤¤·····ss. " 
   ~.  lzgi 1?·;1;l=yg€· _·*  L   _
`      Q-*" `¥   ”·  I;
uh; b Tf,_:%;:*aé·¢f]* __ _;;;`_ _~.;. ~_v_;<»§»;· V
I ;: é—=·¤‘   V.    *16,, ia- =• ‘ -
I     -*9..   F   ·»·F·—»  .   I
,  E,       °   I * I I `F I e,Iv
·   f —·z~;»- »" {   3 M
f     I e ’'‘I e' I‘‘’     # ’ ~—= E   —- I '
,   .“—?“?,;.»? I" ; _ l ·¢  ° ;_·~ v° y w· · " _
  Mary Breckinridge - F ounder 0f the FNS

  Wendover News
A by - Jeremy T. Bush
c We regret to write that Susie   1
ij Hudgins, former author of Wen-   A      
dover News, has resigned from her yi   H rv I ~     '_'£ V Vjti . y
position at FNS. We all miss her.   ,”`;V   V {ge jk     Viy_AA    
I have been designated to   ii‘‘      
_ write Wendover News. I may not be Q"    
J as witty as Susie, but I try. `   .  
. I have been a life-long re- - g
. sident in the beautiful mountains of Southeastern Kentucky  
3 and am a Sophomore at Union College in Barbourville, Ken-  
. tucky.  
‘ Kentucky 's surly weather  
 _ Here we are in August again. The squirrels are search-  
  ing diligently for those last minute goodies to hoard away for  
I winter. The geese will soon be soaring overhead on their way  
south and it has been hotter than a woodpecker's bill on a locust  
I post around here. Practically everything has been sweating,  
panting. or screaming because ofthe heat. Why, not long ago I  
Z found poor little Peach (Wendover resident cat) panting like a  
Saint Bernard!  
. We do have one hope. I have found Kentucky's weather  
· to be as consistent as a chronic schizophrenic. We will have a  
 · month or so ofspring then, BOOM, summer. So, I guess it is like  
I I have always heard, "if you don't like Kentucky's weather,just  
1 stick around; it'll change!" I
I had the pleasure of taking care of the guests while
Karen Thornisee was away on vacation. (I appreciate her more,
{ now that she is back!) I met many interesting people while
 i filling in for her. Among those guests were Louanne Watley,

 ie  .
the Freeman Family and Monica Luke from The Thompson i
. Foundation.
Louanne Watley from Chapel Hill, North Carolina  ·
~ dropped by on July 31. In talking with her, I found that she was J
a writer and photographer. She had recently composed a book
ni which was a collection of poems written by Appalachian '
. women. Louanne had taken the poems, in the authors' handwrit-
ing, and meticulously sewed them into the book. This book was
a grand collage celebrating the Appalachian woman. I wish her
luck with her writing.
A Harold Freeman and his family, from Louisville, Ken-
tucky stayed with us on July 29. They were passing through and _
found Wendover to be the only place to stay in Hyden! They
were happy to find that we were free to keep them that night. _
They had a wonderful stay (except for the feather pillows!). I
found that Mrs. Freeman had been a nurse. That irony leads me
to say, "Where Else but Here?"
Monica Luke from The Thompson Charitable Founda— J 
tion and her friend Jennifer lodged with us on August I. They
stayed here during the Bluegrass Festival. y
During the past few months we have had several »
dinners including one with the Mary Breckinridge Festival ’
Committee members.
We have had the pleasure of hosting two Midwifery
Bound dinners in August. These students come from all regions .
of the continental United States. How happy Mrs. Breckinridge
would have been to see all of those faithful students of mid- ‘
wifery walking around the grounds of Wendover. Her dream
and her heart would surely have been fulfilled. _
The "Shirt" miracle
Jane Eppes and her mother and father from Knoxville,
I Tennessee, brought us bagfuls of a miracle. Jane is a member of
i the National Society of Daughters of Colonial Wars who have
  been extremely generous to FNS and have made us their

i national project. Jane had received 35 shirts during her partici-
 . pation with the March of Dimes Walk America and she asked
 jj Deanna Severance if FNS had a need for the shirts. Mrs.
-v Severance was delighted with the offer and assured Jane that
they would be put to good use. After a series of events, those 35
r shirts multiplied into not 50, not 100 but 600! The shirts were
given to employees and to Home Health patients. We thank
Jane Eppes, Daughters of Colonial Wars, the March of Dimes,
and the Knoxville Track Club for their wonderful generosity.
Local activities
. On August 8th Mary Breckinridge Healthcare hosted
its second annual health fair at the Richard M. Nixon Recreation
5 Center just three miles from Wendover. It was an even greater ‘
success than last year and many people took advantage of the f
free services offered. j
On August l, the Hyden Citizens Bank and the Leslie
,  County Fiscal Court hosted the Osborne Brothers Bluegrass
 · Festival featuring the Osborne Brothers. There were several
more performances by bluegrass groups including Ralph Stanley
& the Clinch Mtn. Boys, J. D. Crowe & New South, Reno J
Brothers, Larry Sparks & The Lonesome Ramblers. Local
groups included Shawn Brock, Charlie Sizemore, Kenneth V
Witt & Northfork, and Vernon Couch & Friends. ‘
l Habitat for Humanity - "Hammering in the Hills"  
_ It was a celebrated day in Hyden on June 18 when j
former President Jimmy Carter and his wife, Roselyn, came to t
Hyden for Habitat for Humanity's "Hammering in the Hills"  
< event. l
Deanna Severance and Barb Gibson attended the event.
Barb served on the original Board of Directors when Habitat
was formed and was so proud to see "Hammering in the Hill"
A come to Leslie County.

Peach and Trish update t
I am happy to report that there has been "peace in the
valley" at Wendover. Peach keeps to himself and so does Trish. _
Peach roams about during the night then catnaps throughout the
day. Trish holes up in her favorite spot, barely visible, just upon
the hill outside the Garden House. Maybe this hot, humid ·
Kentucky weather has some benefit after all. Trish and Peach
are too hot and lazy to argue!
Wendover picnic
On June 6, Deanna Severance decided that all Wendover
‘ employees would have a well deserved picnic. What a day we
had! There was plenty of food, fun and food scraps for Mae's
dog Otis.
Our picnic began at l2 noon. Barb was assigned to the
grill and worked like a little beaver to barbecue pork, chicken
and hamburgers. After everyone stuffed themselves like Christ-
mas turkeys, there was around ofhorseshoes. Dr. Anne sure had -
lots of iron slapping fun trying to make every round a "ringer".
Everyone left filled to the brim and with high spirits.
When Mae got home, Otis was a happy pup! -Jeremy T. Bus/1
  .   . ». *~   ·—;.~~ it. P ._
if     .. _ ·· _ . A _  " ali .       —¤
9 I "’i[°}” m _ i   M .I , s . _, _`
li V   i. » °`\ ~.,__”’ K 'F _·:• . ;\..' {
  .      ?·s‘;i‘>‘.l-r ~ " `
  W ~_   ··~ f   A
il” "    ~~. “ I  r I
    .i’ -   ’   
Dr. Anne trying to make a "ringer"
* .

l`  FSMFN/CN EP News
 . by - Susan Stone, CNM, Acting Program Director
Late August at Midwifery Bound in Hyden, Kentucky,
wearing a sweatshirt and sensing early fall. What a blend of old
' and new! Surrounded by history and tradition but looking
forward to the future of increased numbers of nurse—midwives
and therefore increased health care choices for families.
Midwifery Bound is the five day orientation for new
midwifery students. Students this August traveled from Ha-
waii, Califomia, Maine, New York, Illinois, Ohio, Maryland, .
Colorado and Wisconsin to come and start midwifery studies.
This class also had four students from Kentucky. A school bus
‘ rented from the Hyden School District met the students at the ,
Lexington Airport. They arrived at the School in the evening, l
tired but excited to have finally arrived at the birthplace of
nurse-midwifery in America. Instructors also traveled from far
and wide including California, Oregon, Colorado, Illinois,
  Wisconsin, Pennsylvania, New York, Maine, Maryland and
Georgia as well as one local instructor who lives right here in
Hyden, Kentucky.
This very geographically diverse group of women were
all gathered together for five days for a single purpose, to create
midwives either through beginning their own nurse-midwifery
education or through participating as an educator. Activities
included listening to lectures about the history of midwifery,
i learning to negotiate, planning their clinical experience, defin-
ing state regulations affecting midwives, learning to use visu-
alization, orientation to specific courses as well as songs, skits,
° a picnic and swirmning at the Nixon Center. Classes are held in
the Mardi Classrooms as well as in the Dr. Anne Wasson Room
in our wonderful renovated Barn (the former home of the FNS
A very special event at each Midwifery Bound is when
we bring all the students together at the Big House at Wendover.

 ll F
’ The home of Mrs. Breckinridge brings incredible feelings of
our roots as for all midwives, and especially for our new i
students, as they begin the pathway that, for many of them, has »
· been a lifelong dream. Mrs. Deanna Severance, President of the
FSMFN, is a fountain of information regarding the history of
. the FNS. She tours the students in groups through the Big l
  House providing historical information that fascinates the
j students. We continue to uphold tradition by beginning dinner
E with "Amazing Grace". The dinner discussions always bring
  stories for the students. Two very special participants attend
i_ these dinners and are able to provide first hand stories of the
i past. These include our own instructor, Kitty Ernst, CNM,
j founder of CNEP, and 1952 graduate of the FSMFN. Our other
, important guest and expert story teller is Dr. Anne Wasson who
came to the Frontier Nursing Service in 1969 as a Family
I Practice Physician and at one time was the Director of the
Q School. I
» During this Midwifery Bound, I had the honor of U
_ staying at the Big House. While prowling through the books on
  the many bookshelves, I came across the FNS Quarterly
  Bulletins from 1930 through the present. As I perused the many
  articles and stories, I was fascinated by the historical news and
  tales. I picked some special excerpts and when the students
  were at the Big House for dinner, we all sat in the living room
  after dinner and instructors took turns reading these excerpts.
  Everyone there enjoyed this and we all learned just a little bit
  more about the hard work that was done by Mrs. Breckinridge »
  to improve the health care in these Kentucky mountains.
  On a beautiful sunny Sunday morning, the students and
  instructors packed their suitcases and gathered outside the A
i chapel for last minute good-byes and "Circle Up". "Circle Up"
  is one ofthe School's traditions. All students, staff, and instruc-
  tors come together and link arms. There is a quiet time where
  anyone is invited to eitherjust think or to share their feelings.
1 We frequently end the "Circle Up" by singing the CNEP song.

  Then each student walks around the chapel and rings the chapel
j bell. When the bell rings in Hyden it means one of two things;
· either a student is starting midwifery studies or a midwife has
i graduated from the FSMFN (when students return to graduate,
they also ring the bell).
` Our next endeavor is graduation which will be held in
Hyden on October 19, 1997. -Susan Stone
l CNEP - Community Lessons
. I remember Kitty saying that it isn`t our computer that
. will be teaching us midwifery but our community. I am finding
· this true in so many ways. It is so clear that I am building on the
base of living in this small town in Vermont. I am finding
receptivity from the women who work in the grocery store
when I talk about midwifery as they've seen me zoom through
the store with kids in tow. The general practitioner who is caring
 I for my father-in-law just opened her doors to the first CNM
practice in this area. The support of friends who help my kids
from baseball to soccer and who meet me at the local pool asks
me how the pharmacology exam went. They are like angels in
my day. I find strength from the mountains when it all seems a
bit too much. Even my overgrown garden reminds me that the
perennials survived the winter and will give their healing
tinctures in spite of the weeds.
I know that each time has its own season of productivity
’ which helps my perspective about finding my own rhythm and
trusting that all will work together for good . . .
_ But too, I marvel and am thankful to the CNEP commu-
nity that brings help, support, information and nurturing. I
wonder if part of becoming a midwife doesn't also entail
midwifing ourselves, and allowing others to midwife us . . . I
am very grateful for all those weavers of midwifery that made
this program possible for me to do today. I couldn‘t do this if I
had to move. The resources at hand are teaching me so much

 ll} `  I I
  { . . . I am learning much more than what goes into the modules. B
* But, maybe someone knew that at the start. Thanks to this
· I midwife community. -Mart/ta Redpath, CNEP student .
li "One reason to choose CNEP"
  The following is a recent conversation on the FSMFN
  Bulletin Board System, between Joani Slager, CNEP Faculty, and
  Sherri Benson, CNEP Class 14, student regarding the NACC B
  Birth Center Course.
    . . it was the birth center course of CNEP's courses that helped
i , me make my decision to choose CNEP over University of Illinois
  in Chicago, among other things such as the clinical requirements.
  One MD I talked to said that it was a waste of time, because that
  is what you hire office managers for, but then in the next sentence
  he said that he wished he had some type of business management I
  Thank you Kitty, for yet another reason CNEP is a
i wonderful schoolll —S/ierri Benson/./oani Slager  
Editor's Note f
I This Quarterly Bulletin was mailed late due
Q _ to a delay in the Auditor 's report. Also, ·'
g i "Beyond the Mountains " is not included A
  in this issue due to limited space.

~ Courier Program News
` by - Karen Thomisee
This summer has flown by and we are already saying
good—bye to another group of Couriers! Summer is always a
I special time to be in Leslie County, and our most recent crew
will take home memories of swimming in the pool and in the
_ river, July 4th fireworks, square dances, the Osborne Brothers
Homecoming Festival, many long evenings in conversation on
. the Garden House porch and the hot and humid Kentucky
I weather. Jen, Nina, Stacy, Ashley and January successfully
navigated their way through an array of dinners and animal
adventures during my absence on vacation. I enjoyed my
vacation in North Carolina, but it feels good to be back at
Wendover with Trish and Peach! Here is more about what the I
Couriers have been up to:
Jennyfer Duckettjoined us as a pre-med rising senior
  at Duke University in Durham, North Carolina. Jen is originally
_ from the Appalachian mountains of North Carolina and has
enjoyed the opportunity to explore the hills of Kentucky. She
was a regular on Home Health visits as well as at Hyden Clinic.
She also enjoyed shadowing our social worker, Karen Sallee. In
her spare time she diligently stitched labels into countless baby
Nina Ross, a pre-medjunior, joined us from Berwyn,
I Pennsylvania and attends Yale University. Nina immediately
involved herself by organizing and teaching dance workshops
in the summer school program. Nina, whose interest is in family
· practice, divided her time between Beach Fork Clinic, Dr. Jean
Sullivan and Home Heath visits.
Stacy Boyd came to us from Sarasota, Florida, where
she is a senior at New College. She is originally from LaGrange,
Georgia. Stacy, an anthropology student, lived the life of a
midwife by attending births with Betsy MacMillan, CNM.

Stacy also conducted interviews with women in the region on  4.
their birth experiences and still found time to eat Cinda Morgan‘s .
home cooked meals and tutor her in reading. _
Ashley Kidd is a sopomore at Williams College in E
Massachusetts and claims New York City as home. Ashley’s _
interests include social work and health care. While in Leslie -
County, she involved herself in Home Health and Hyden Cl i nic.
She also shadowed Susan Ziegler, FNP, at Community Health
Center and Karen Sallee, MBHC social worker. In her spare
time Ashley tutored Huta Youssef (Dr. Yousset`s mother —
Family Practice Physician in the Hyden Clinic) in English and
‘ ate tons of Huta's amazing Syrian home cooking! She also
, learned to hand build a rocking chair. The Courier craft tradition
January Simpson, from Huntington, West Virginia,
joined us as a soon-to-be senior at Hanover College in Indiana.
January is interested in medicine and philosophy. She spent
much of her time visiting Home Health patients with Lisa Terry, J
RN. January was also a companion to Edith Wooton, a fearless
I keeper of our animals and an aspiring quilter!
  ‘  ‘!      .,,      »-—»    if S     L   tti      
g if Y  ` •~·   '_ U  ,,.,      V}, #*3 ygier i ” ’
1 5;,    -   ·»·’   ,. '’`    %    ·    ¢· Q P .
’  J  x w ; t `Q    ..# ‘  *  J}  , M \     J i ·  . ‘
{ ia  rw I;   ,1 » -I  · { Q Vid        3%   , .—
l   EA} `-J` 4.,, <—k¥ (r _ \·Z    U .  
    O .  _ _» ff  p
  ,· ‘
Y . J   g  (.f
l €§°%i¤,,i_% r I *'\    I
‘?     Ai;   _   Qé ffif   *
ii lyhl { fr     47 .
  Stacy Boyd, ,]enny'er Duckett, Nina Ross

Z ,     iv      ‘ · ` 4 V A .     F r
- ‘·.e_ lbxk   V   {  i '_v_   ‘ ·     "   ·  1   _ A A 4
·»"·.*'·_e¤»· ·.~ ¢'·', ' I ~ ‘ Vi i‘·fY ’€ — ll     M '; '
      `        ’*·‘   r 
`   ______ t `;—;gg_f—Tg;€;.§%>—~;,e;;}_  Q `  
q ~, \      r v/2, .1; »   '{ - ,;·¢   -~e
  `   .l,,   ~\ K
  fl   `»‘·        * .
é _· A   lf) (/tx.
A . » W an
  :*‘   . ·     ll
    ‘ X I  Y
Ashley Kidd and January Simpson
Former Couriers
 _ Karen Mangold ( '97) wrote us recently from her home
in Rochester, New York, and sounds quite homesick for Ken-
tucky. She has put her quilting skills to work making pillows but
says she is afraid the memories of sitting around the television
room with all the Couriers sewing together will flood in
whenever she tries to put a pattern together.
Our congratulations goes out to Beth Muzzy ('97) who
will enroll in nursing school this fall in Burlington, Vermont.
She continues to educate herself in midwifery as she prepares
· to become a midwife. Beth wrote and said she is burned out on
the city and finds herself way too often daydreaming of
Wendover. She said she misses Kentucky, FNS and all the
wonderful people she met here.
Katie Gamble (’96) wrote and said that she is applying
to medical school next year and is still considering obstetrics.
She said she will always remember the lessons about life and
healing that she learned at FNS.

‘   Jenny Cox ('96) has finished her first year of nurse- i
  midwifery school at the University of Pennsylvania. Jenny
il wrote and said that being at FNS helped her gain respect for  -
  nurses and the discipline of nursing. She said it is almost I
I   unimaginable how many roles nurses fit into, and she has yet to ;
{ discover them all.
  Krista Nickerson ('95) wrote a wonderful letter from
  Mongo, Chad, where she works for the Peace Corps in commu- ;
  nity health. Her activities have included organizing education .
  at the local health center for the pregnant women and women  
  with sick children, and conducting research on malnutrition.  
  Krista is considering going to midwifery school when she  ~
 i returns to the states.  
  We received a postcard from Sorqa Herbert ('92)  
  letting us know that she is pursuing a Masters in Public Health
l degree in Berkeley, California.  
i We had a wonderful visit with Sandy Schreiber ` 
  (Sandy Gray, ’57) when she dropped by Wendover. Sandy V
Q resides in Louisville and is a Trustee of the Frontier Nursing l
l. , p     Damonica Huff ( '93)  
Q S.     U ·  .. married Ken Steven Partin  
  ,, —      .,;,, ;   t   gn July 26, 1997. Their Y6-  
_ l     i   hersal dinner was held at the  
Q}     Big House. Damonica is a  
i .   _*; 0 {      student at the University of ;
_ y   ( Kentucky and is the only E
_   G   .a·_; person from Leslie County g
Z if Q to serve as a FNS Courier. `

  _ _,,  -LL.L. -  _, .Q.U!§liTEBLY BEJLEETINI   ....   . .}.5
for the Fiscal Year
May l, 1996 to April 30, 1997
_ As has been our custom since we were one year old. we present
. our annual report ofthe fiscal affairs and ofthe field operations
of the Frontier Nursing Service, Incorporated.
l We have, as in previous years, divided our report into two A
sections. One section is about money. and one is about work.
The figures that follow are taken from the Balance Sheet. the
‘ Exhibits and Schedules of the Audit for the fiscal year which
ended April 30. I997.

1; I
. Q ·
  To the Board of Governors ~
I FNS, Inc. and Affiliates
I Wendover, Kentucky V. 
,   We have audited the accompanying combined statement of financial position of FNS, lnc. and
  Afhliates as of April 30, 1997, and the related statements of activities and cash flows for the year   C
3 then ended. These financial statements are the responsibility the Service‘s management. Our  
{ responsibility is to express an opinion on these financial statements based on our audit. The  
I financial statements of FNS, lnc. and Affiliates for the year ended April 30, 1996, before they Z
I . were restated for the matter discussed in Note 9 to the financial statements, were audited by I
l ! . other auditors whose report dated June 20, 1996, expressed an unqualified opinion on those  
  Q statements.  .
I 1 . 
l ° We conducted our audit in accordance with generally accepted auditing standards. Those  f
  I standards require that we plan and perform the audit to obtain reasonable assurance about ,
  , whether the financial statements are free of material misstatement. An audit includes g
  examining, on a test basis, evidence supporting the amounts and disclosures in the financial  I
  statements. An audit also includes assessing the accounting principles used and significant  . L
l estimates made by management, as well as evaluating the overall financial statement {
E ‘ presentation. We believe that our audit provides a reasonable basis for our opinion. j p
I ~.
  y In our opinion, the financial statements referred to above present fairly, in all material respects, I-
l the financial position of FNS, Inc. and Affiliates at April 30, 1997, and the results of its  Q
E A operations, changes in its net assets and its cash flows for the year then ended in conformity  
Q F with generally accepted accounting principles.  
E  July 17, 1997   F
ll  ,
l '  I-
1 ‘ ,. 
s =
g  ;

April 30, 1997 and 1996
I 1997 1996
ar Current assets:
ur Cash and cash equivalents $ 1,535,037 $ 1,815,646
le Accounts receivable, less allowances for
Sy uncollectible accounts of $1 ,024,000 in 1997
;; and $817,000 in 1996 2,828,870 2,966,975
Accounts receivable, students tuition 1,419,547 1,491,578
Investments (Note 5) 18,808,650 15,878,213
;€ Inventories 451,818 356,746
ut Prepaid expenses and other current assets 85,345 98,688
as Total current assets 25,129,267 22,607,846
nt Long-term portion of accounts receivable, students tuition 220,050 442,119
Property, plant, and equipment:
_ Land 182,174 177,062
rs· Buildings 4,231,110 3,708,368
is Equipment 6,244,503 5,159,994
y Construction in progress 239,618 544,26707
10,897,405 9,589,684
Less accumulated depreciation (7,060,193) (6,622,67Q
_ Net property, plant, and equipment 3,847,212 2,967,006
I Present value of beneticial interest in outside trusts 539,315 489,000
Total assets $ 29,735,844 $ 26,505,971
See accompanying notes.

 1|l —
1 5 i
l    Q
li  I
,1 1997 1996
ii -
i  LELACBII l.,l,,T l_E2S Qi_
  Current liabilities: ·
  Accounts payable $ 504,099 $ 1,487,302
;  Accrued salaries and withholdings 311,937 298,744 _·
QT Accrued vacation expense 310,243 384,761  .
 ? Deferred tuition, students 1,710,829 2,254,588  ·
1   Payable to third-party programs 335,774 243,170  ·
5,, Other current liabilities 1,120,962 1,017,233  Q
{ Total current liabilities 4,293,844 5,685,798  V
g  Capital lease payable (Note 11) 837,482 65,637 j
Q, Gift annuity reserve 75,793 39,481
  Long-term portion of deferred tuition, students 635,063 442,119 f
Q 1 1 Commitments and contingencies ·
,  Total liabilities 5,842,182 6,233,035 _Q 
  NE T A s s E T s  
i  .
i Net assets: ?
¤ Unrestricted 19,457,360 16,534,415 Q
i~ Temporarily restricted 1,821,906 1,253,730 ·
, Permanently restricted 2,614,396 2,484,791 J
2 Total net assets 23,893,662 20,272,936 A
 Q Total liabilities and net assets $ 29,735,844 $ 26,505,971 i
é 1  A
yi i
 1 `

 [ Years ended April 30, 1997 and 1996
» 1997 1996
302 ,
744 · Changes in unrestricted net assets:
761 I Revenues and gains:
588 _ Net patient sewice revenue $ 15,835,128 $ 14,933,196
170 , Contributions 980,681 782,889
233 Education revenues:
798 Tuition and educational fees 2,557,422 2,426,478
; Federal grants 375,956 535,801
537 ‘ Other grant revenue 35,045 0
481  ~ Net realized and unrealized gain on investments 1,995,967 1,506,614
I 19 “  Other revenues and gains;
 ‘ Investment income 712,907 597,971
 — Other revenue 692,425 5 255,235
_ Total unrestricted revenues and gains 23,185,531 21,038,184
)35 _ Net assets released from restriction due to RTT! E
I satisfaction of program requirements 1185,917 _ O
Expenses: KT
Salaries and wages 9,006,560 8,705,820
Fringe benetits 1,691,891 1,524,851
. Medical services, supplies, and other expenses 6,698,948 5,992,482
115 Q Facility costs 1,046,056 944,597
730  7 Provider taxes 286,829 265,676
’9l  5 Provision for bad debts 1,121,420 @67,819
936 , Total expenses 19,,831rl% l§,5_O],2§
J  Increase in unrestricted net assets 5 53,472L@I_ 55536,939
l71 —
- Changes in temporarily restricted net assets:
_ Contributions 97,095 351,225
 , Change in present value of annuities 40,199 0
A Net assets released from restriction (118,917) O
J Net realized gain on long term investments V     0 _' 265,%
_ Increase in temporarily A
 i restricted net assets 18,377 6_156@l5
 ; Change in permanently restricted net assets:
 ? Contributions 79,290 8,180
1 Present value of beneficial interests in outside trusts 50,315 _i489,0Q0A
5 Increase in permanently restricted net assets 129g§05 r497l8Q_
Increase in net assets 3,620,726 3,650,580
  Net assets, beginning of year 20,2Qg g_16,6Q,§§6
Net assets, end of year $ 23,§>§_,@2 $ __2g,272