xt7c862b9q44 https://exploreuk.uky.edu/dips/xt7c862b9q44/data/mets.xml The Frontier Nursing Service, Inc. 2001 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. 77, No. 1, Summer/September 2001 text Frontier Nursing Service, Vol. 77, No. 1, Summer/September 2001 2001 2014 true xt7c862b9q44 section xt7c862b9q44 FRONTIER NURSING SERVICE  
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 US ISSN O0l6—2l I6
Introduction to FNS - Deanna Severance I
Mary Breckinridge Healthcare News — Mallie Noble 2
Wendover News - Christine Collins 6
FSMFN News — Susan Stone and Dr Julie Maifell 13
Website Information I4
Courier Program News - Barb Gibson 15
Annual Report 18
Report of Operations 37
In Memoriam 42
Note: Photo on cover of last QB (Volume 76 Number 4) - FNS nurse
Anna Mae January with local children. Photo taken by Earl Palmer.
Cover: FNS nurse opens up for the day at Hell-for-Sartin Clinic in
1953. Photo by Thomas V Miller, The Courier Joumal.
Frontier Nursing Service Quarterly Bulletin
Published at the end of each quarter by the Frontier Nursing Service
Subscription Price $5.00 a year for Donors/$15.00 for Institutions
Volume 77 Number 1 Summer/September 2001
Periodicals postage paid at Wendover, Kentucky 41775 and at addi- _
tional mailing offices. POSTMASTER: Send address changes to FNS,
Inc. 132 FNS Drive, Wendover, Kentucky. Copyright FNS/Inc. 2001
All Rights Reserved. \_

Frontier Nursing Service
U you have never been introduced t0 the Frontier Nurs-
ing Service we would like to take this opportunity to brief you on
` the history and the on-going work of the Service. Please share
this information with a friend
Born in 1881 into a prominent American family, Mary
Breckinridge spent her early years in many parts of the world -
Russia, France, Switzerland and the British Isles. After the death
of her two children, she abandoned the homebound life expected
of women of her class to devote herself to the service of others,
particularly children.
Mrs. Breckinridge established the Frontier Nursing Ser-
vice (FNS) in Leslie County, Kentucky in 1925, then one of 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 healthcare to fami-
lies throughout an area of 700 square miles.
Until her death in 1965, Mary Breckinridge was the driv-
ing force behind the work of the Service whose influence today
extends far beyond eastern Kentucky. Through the Frontier School
of Midwifery and Family Nursing, hundreds of nurses have been
trained and this important concept of family healthcare has been
carried throughout the world.
Today, the FNS is organized as a parent holding company
for Mary Breckinridge Healthcare, Inc., (home health agency, two
out-post clinics, one primary care clinic in the hospital, Kate Ire-
land Women’s Healthcare Clinic) and for the Frontier School of
Midwifery and Family Nursing - the largest midwifery program in
the United States.
D Remarkably, the purpose and philosophy of the FNS has
remained constant since 1925.

Mary Breckinridge Healthcare News
-Mallie Noble, Administrator
Rural Health Association
On May 31, I attended the Rural   e ii   y
Health Association meeting in Somerset,     a _
Kentucky. Topics included peridontal dis-     ` ( Q
ease in pregnancy which leads to prema—   _  g    
ture births and costs the state of Kentucky ‘ F   :;=;     'i l J
$90 million per year. Dr. James Cecil, the ‘  ~    
State Dental Director, suggested long term   _ _Q S
committment beginning with teaching and .   ”``;    
education of parents and training of physi- Mallie Noble  
cians and FNPs regarding flouride varnish with children begin-  
ning at six months of age.  
Kentucky Hospital Association (KHA)  
On July 26, I attended a legislative committee meeting at  
the Kentucky Hospital Association’s (KHA) headquarters in -
Louisville. Topics included the Washington Legislative Update;  
State issues including updates on Medicaid DRGs, hospital rates E
and long term care Medicaid payments; and the Federal Wage ln- i
dex Bill. It is critical that the Federal Wage Index Bill be increased 5
for Kentucky. i
On August l6, Sarah S. Nicholson, Vice-President of ?
KHA, other Administrators and myself, attended a meeting at the Q
Mary Mount Hospital, London, Kentucky, with Senator Jim .
Bunning and his staff. Topics included the Federal Wage Index  
Bill and the Healthcare Workforce Shortage. Thanks to Mike Rust,  V
KHA President and Sarah S. Nicholson, Vice-President, for their  
hard work and dedication.  
Awards of Excellence  
On June 6, Deanna Severance, CEO, and I attended the -
Sixteenth Annual Awards and Recognition Program of the Cabi-  _°
net for Workforce Development and the Department for Technical s 

Education in Frankfort, Kentucky. Leslie County had several indi-
viduals and groups being honored. Frontier Nursing Service/Mary
Breckinridge Healthcare, lnc. received the Outstanding Organiza-
tion Award for their support and services for improvement of vo-
. cational technical education programs and for providing opportu-
V nities for students.
. Jennifer Michelle Napier, a 2000 graduate of the Leslie
  County Area Technology Center and the Leslie County High
  School, was honored as the Kentucky Outstanding Secondary Stu-
dent. Jennifer was recognized for her leadership abilities, good
citizenship and her appreciation for the American Work Ethic.
Others receiving recognition as state finalists included
{ Victor Pennington, Carpentry Instructor at the Leslie County Area
[ Technology Center, as the Outstanding Beginning Teacher; Nadine
l Shepherd, Administrative Secretary, as the Outstanding Staff
  Achievement (non-certified) and Betty L. Huff, Principal, as the
i Outstanding Staff Achievement Award (certified). Congratulations
l to all winners!
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l Lef to right — Deanna Severance, CEO of FNS; Mallie Noble,
 . MBHC Administrator; Victor Pennington, Betty Huy and
i Nadine Shepherd all from the Leslie County Wrcational School.

Nurse Aide Training Program  
The Mary Breckinridge Healthcare/FNS education depart- Y
ment has been working diligently on the State Registered Nurse
Aide Training Program. We now have f`our staff certified to teach Y
the Program - Denise Kilburn, Nancy Couch, Roxanna Combs l
and Tammy Feltner.
Pending approval for a providership, we plan to admit the  
first class mid—September. Thanks to Teresa Napier, RN, and other g
stat? at the Leslie County Area Technical Vocational School for I
allowing us to share the nursing lab. `
New Birthing R00m
The Ladies Auxillary donated funds for the interior deco-
rating of`a new birthing room at MBHC. This room provides a
home- like atmosphere for the pregnant mother. We are very thank-
ful to the Ladies Auxillary for making this possible. Glenna Estep, I
Bearbranch, Kentucky, was the first patient to deliver in the new  
birthing room.  
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Glenna and Alexis Michelle Estep '

Welcome to Dianna Schuster, FNP, who came on board
W July 23. Dianna will be working at the rural health clinics.
Our deepest sympathy goes to the family of Nora Hensley,
wife of Leonard Hensley, Housekeeping. Also, to the family of
i Timothy Burns who was the grandson of Drucie Webb, CNA, on
g medical/surgical floor.
i Staff A ctivities
  On August l, the Quality Improvement Program and
E MBHC Care Committee held their 6th Annual Health Fair at the
i Richard Nixon Center. A variety of booths (60) were on hand to
i provide information on healthcare issues, to check blood pressures,
  blood sugars, oxygen levels, cholesterol levels, dietary counseling
l and provide information on various community services available.
  Approximately 300 community members attended the fair and the
  Kentucky Blood Center obtained 37 units of blood donated by
  MBHC employees and community members!
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Home Health Booth - [ef to right - front: Willa Morris, Home
Health Director; Mary Haj CNA; Back row — Betty Lashon,
' CNA; Charlotte Estep, Receptionist and Kendra Bush, Billing
- Specialist.

Wendover News
by Christine Collins
We have had a busy summer
at Wendover. Our Bed & Breakfast g I I, , V
staff have hosted guests who have  
visited before as well as some new     _‘'= I "   I
ones.We enjoy talking with each one    
of them.     I
Denise Kilburn. Director of "   yiytg_   1  
Nursing, taught CPR classes to Wen-  ' · j
dover staff and we are proud to re- Christine Collins I
port that everyone was certified! I
On August l0, we held our annual FNS picnic at Wen- I
dover with Lexington office staff attending. JG and Juanetta Mor-  
gan, former staiT members, were also in attendance. After the pic- l
nic everyone attended a birthday celebration for Dr. Anne who is a  
patient in the hospital.
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Wendover ‘picnic" time. Lef to right - JG Morgan, Juanetta ·
Morgan, AnnDraia Bales, Heidi Froemke, Julie Majell,
Beulah Couch, Patra Simpson, Deanna Severance, Carl Sever-
ance, LouAnne Roberts. ;°

 { if if ifiifi I T TT iffii E IT "R
  Wendover grounds continue to look beautiful. Maintenance
is busy putting a new coat of paint and new metal roofs on the Big
House, Barn and all of the outbuildings. We look forward to the
fall colors and invite you to come and visit!
. Below is a list of overnight guests, special luncheons and
I tours since the last report:
  May I5 Luncheon for nine students from Hazard Com-
} munity College and Denise Kilburn, Direc-
j tor ofNursing; Nancy Couch, Med/Surg Man-
  ager and Roxanna Combs, Clinics Manager.
  May 20 Susan and John Frank, Newport, Kentucky.
  May 22/23/24 Susie and Brad Stewart, Jekyll Island, Georgia.
l May 23 Luncheon for Hazard Community College nurses
aide graduating class. In attendance were Me-
  lissa Sparks, Hyden Manor Nursing Home; Teresa
i Napier, Leslie County Area Technical Vocational
I School NursingClass Instructor; Denise Kilburn,
l MBHC Director of Nursing and Roxanna Combs,
l MBHC Clinics Manager.
l Judy Vanderhart, Tiffany Rosenfield and Pat
l Brown, Dallas, Texas.
I May 25 Dave Sawyer and Dr. Ted Ballard, Lexington,
Kentucky, visited. Mr. Sawyer knew Mrs. Breck-
inridge when he worked on a landslide at Wen-
dover in the late 60’s.
' May 29/30 20 guests from McKendree College, Lebanon,
ii Kenneth Tuggle and Charles Allen, Frost Brown
{ Todd, LLC, Lousiville, Kentucky.

June l Former couriers Megan Stumn, Madison, I
Wisconsin, and Miranda Gillespie, Mobile, Ala-
bama, visited for five days. I
June 5 Former FNS midwives Margaret Willson "Miss I
Maggie", Somerset, England, and Joanne Vickers
Peterson, Charleston, South Carolina, visited. Ms. I
Willson was Hyden Hospital Supervisor and Dean I
of the Frontier School of Midwifery and Family  
Nursing in 1958. She left FNS in l967. Ms.  
Peterson was a staff midwife in 1988.  
June 7 Dianna Schuster, FNP. Interview at MBHC. I
June 20 Noel Fernandez, Pomona, New York, was here  
for ten days working with Dr. Anne on her book. I
June 22 Tammy Bruner, Wanda Goode and her family,  
Lexington, Indiana, stayed at Wendover while A
attending a funeral in the area. I
June 23 Janice Hall, Sadieville, Kentucky, and Debbie I
Browning, Georgetown, Kentucky, stayed at Wen-
dover while attending a friend’s wedding in the
June 27 Billye Molfatt, FNP, Albuquerque, New Mexico.
Bill and Pat Killman, Hartford, Kentucky.
June 29/30 James and Debbie Johnson and their daughters,
Muskego, Michigan. ·
June 30 Courier LouAnne Roberts’ parents, Kenneth
and Kittye Roberts, and a friend, Lexington, 'I
Kentucky. Q

L July 2 Herman Holt, Hillsboro, Ohio; Melvin Holt,
l Ocala, Florida; Larry Holt, Davie, Florida, and
Jeamie Guerrero, Pompano Beach, Florida, spent
two nights. Herman Holt worked for Mrs. Breck-
, inridge when he was a boy.
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i LM 10 right: Herman Holt, Melvin Halt, Jeanne Guerrero and
Larry Halt
July 8 Ted and Lynn Lapierre and their children, New-
ington, Connecticut, spent the night while visit-
ing Dr. Anne. Mr. Lapierre is Dr. Anne’s nephew.
July 8/9 Russell Mead and his wife, Hendersonville,
Tennessee. They were in Hyden working with
Habitat for Humanity.
July 16 Kim Trout and her son, Huntingdon, Pennsyl-
 ‘ vania.
_ July 24 CNEP Level lll dinner with 27 in attendance.

i July 25 Robert Johnson, Chattanooga, Tennnesee.  
July 31 Kenneth Tuggle and Charles Allen, Frost Brown
Todd, LLC, Louisville, Kentucky.
August 1 Dinner for Allied Health students/faculty,
Medina, New York. Ten in attendance. .
August 3 The Osbome Brothers and their band members  
spent the night while in town for their Annual  
Bluegrass Festival.  
Noel Femandez, Pomona, New York, stayed at  
Wendover for five days while working with Dr. I
Anne on her book. ,
August 4 Sue Anne and Karen Bottomley, Columbia, Mary  
land, stayed for two nights while visiting Dr. Anne.  
Ms. Bottomley is Dr. Anne’s niece. j
August 10 FNS annual picnic was held.  
August 18 Marge and George Stevens, Fort Washington, l
Maryland. Mrs. Stevens is Dr. Anne Wasson’s [
August 23/24 Several faculty members from the FSMFN stayed
at Wendover during their Midwifery/CFNP Bound
orientation classes.
Tours I
June 26 Nancy Ashworth, Eastern Kentucky Magazine,   ‘
Viper, Kentucky. E
July 9 Ted and Lynn Lapierre, Newington, Comiecti- i

l July 23 Sharlene Clemins, Hazard, Kentucky, and four
T friends.
i July 25 Roy and Brenda Boyd, Cedar Bluff, Virginia, and
, Ricky Simpson and his wife, Wendover, Kentucky.
T July 3l Georgia Ledford, Big Creek, Kentucky, and her
August l Ten students/faculty, Allied Health, Medina, _
New York.
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Students from Allied Health - le]? t0 right back row: Katie
Granzow, John Huber (Instructor), Emih> Smith, Melinda Cole.
Front row - Lisa MacEvoy (Instructor), Deanna Major; Jessica
Martin, Valerie Childs, Sonia Tavsor, AnnDraia Bales (FNS
Tour Guide)
I August 6 Sue Anne Bottomley, Columbia, Maryland.
J Early March, FNS Nurse—Midwife Molly Lee, England,
, visited Wendover and other friends in the community. Miss Lee

· was at FNS for different periods of time from l955 until mid-  
`70`s. She was Dean ofthe Frontier School ofMidwifery in 1968.  
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Molly Lee [
Bed & Breakfast Inn Comments F
"What a blessed memory of goodness and kindness and
honesty we still have in our country. Wendover is a living example
ofthis truth. God is so good to help us keep a place like this still
going on. lt’s like coming home".
Jeanne Guerrero, Pompano Beach, Florida
"What a beautiful home filled with wonderful history. This
is wonderful! l returned after 20 years!" {
—Susan and John Frank, Newport, Kentucky l
"Once again, my thanks to Christine, Linda and your en-  
tire staff for making our visit a pleasant one as always. l am al-  
ready looking forward to my next return". —Lar1jv Holt, Davie,  
Florida ·*

T Frontier School of Midwifery and Family Nursing
Susan Stone, FSMFN Dean and President and
Dr: Julie Markll, C FNP Director
  qt, ‘ ·   ’i  
l Susan Stone Dn Julie Marfell
  What an exciting time at the Frontier School of Midwifery
  and Family Nursing (FSMFN)! August 22-26, 33 Community-
g based Nurse—Midwif`ery Education Program (CNEP) students and
{ nine Community-based Family Nurse-Practitioner Program
  (C FNP) students were on "the hill" attending newly renamed "Fron-
I tier Bound". A large banner stating, "Welcome to Frontier, the
5 FSMFN welcomes it’s newest class" was hung across Route 42}
§ to greet the students and faculty as they entered Hyden. Within 20
l minutes of the banner being hung an undergraduate nursing stu-
  dent from Hyden was in the office at the School requesting infor-
  mation on the CNEP and CFNP programs.
E It was a terrific Frontier Bound. The energy that the stu-
i dents bring to the faculty and staff is unbelievable. There was lots
  of singing, some tears of joy and many new friendships formed
§ over those four days. The next Frontier Bound is November 7-l l,
) 200l .
Y We also have a student that is trailblazing. Rosalind
  . Klinepeter is a 1999 graduate of CNEP and has returned to FSMFN
to complete the CFNP Program. She is the first student to retum
  to complete the CFNP Program. We continue to have inquiries
  about how to complete both programs while they are enrolled. lt
  has been our plan to offer our students this option and we are
li continuing the process of making a smooth track for the students

' to complete both certificates if they so desire.
The faculty is thrilled to have a space dedicated to faculty
practice offices and a conference room in Morton-Gill building
(School). The office and conference room are located at the front
of the building on the second floor. Dr. Anne Wasson graciously
donated some furniture and artwork to help furnish the conference
room and oliices.
Frontier Nursing Service - www.frontiernursing.org {
FSMFN Community—Based Nurse-Midwifery Education V
Program(CNEP) - www.midwives.org .
FSMFN Community—Based Nurse—Practitioner Program l
(CFNP) — www.frontierfnp.org E

Courier Program News
—Bc1rb Gibson
Rebecca Lesser, Berkeley, Calif- ” Y     $,2
ornia, was here from May 20 — August 3.   V yr»·          ‘
She is very interested in midwifery and i   _ l
Spent a lot of her time shadowing mid- 2,;  t‘i,   ’ yffvlyy V
T wives as well as FNP’s and other pro- rt!    SR?
  viders. Rebecca plans to have a career   ( 
l in nursing. r  ~ . 
  Rebecca Lesser
{ LouAnne Roberts, Lexington, 3  ; .
  Kentucky, participated in the Program   T in _\&  
i from June l — August 24. LouAnne is   V 1 {
interested in becoming a FNP. During  
I her time here she shadowed almost all A2 _ y
  of the providers. LouAnne moved to   _   T
j Brooklyn, New York after leaving FNS. fig
l LouAnne Roberts
l Renee Railey, Madison, Wisconsin, arrived August 20 and
l will be here for eight weeks. She graduated from the University of
l Wisconsin and has an interest in public health.
  Katie MyGatt, Lincoln, Massachusetts, arrived August
  26 and will be here for l2 weeks. Katie graduated from Concord
  Academy, Lincoln, Massachusetts, and will be attending
  Middlebury College, Middlebury, Vermont.
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i Renee Railey Katie MyGutt

' Farmer C0urier News
Michelle Lee (‘97) graduated from Harvard in 1998 and
is living in Brooklyn, New York. She works at the Greater New
York Hospital Association which represents over 200 hospitals
and nursing homes in the New York metropolitan area. Her job
involves doing research and writing grant proposals for various
health policy projects.
Ann DeB0urcy (‘98) graduated from Princeton Univer-
sity, Princeton, New Jersey, during June 2000 with a degree in
Molecular Biology. Ann has been accepted into New York Medi- g
cal College in Valhalla, New York. A
JennU”er Swisher, Catherine Th0mps0n, Mariah Mattley
and Karen Thomisee (‘99) wrote that Karen is a photographer
for a paper in North Carolina; Jennifer is starting her fourth year
of medical school; Mariah is engaged and starting her fourth year l
of college. She is the proud Mom of an Elkhound named “Juno"
and Catherine just finished nursing school and will soon start work p
in Manhattan. J
These four just had another Courier reunion, this time in .
Montana. »
Amber Waters (‘00) wrote that she is now a "married 1
Peace Corps Vo|unteer" in El Salvador. Amber and her husband,
Chuck, were married November ll, 2000 and have lived in El
Salvador in the epicenter of San Vicente since late January. Amber 4
and Chuck are teaching Reproductive Health, English and tutor- l
ing math in their small village of Santa Marta which is a refugee
community that was heavily hit during the war.
Megan Stumn and Miranda Gillespie (‘00) visted Wen- ~
dover in early June and wrote the following: “Driving in, we felt
like we’d never left. Everything pretty much looked the same and
it was hard to believe that it had been a year since we’d first set  
eyes on the place. We’ve had a great time in our four days here

talking to Dr. Anne, seeing Barb and everyone else at Wendover
and hangin’ out with the new, fun Couriers. It makes us a little sad
that we aren’t going to be spending the summer with them."
Megan is getting ready to start medical school at the Uni-
versity of Wisconsin and Miranda received a Fulbright Fellowship
to Canada (as did Erin Banta who was also a Courier in the sum-
mer of 2000). Dana Traverg the fourth Courier in this group, will
be getting her RN/Masters at Johns Hopkins in the fall.
E Due to limited space because of the Annual Report,
l "Beyond the Mountains” was not written for this
issue ofthe Quarterly Bulletin

· Il
For the Fiscal Year A
May 1, 2000 to April 30, 2001 I
Preface p
As has been our custom since we were one year old, we present
our annual report of the fiscal affairs of` the field operations ofthe
Frontier Nursing, Incorporated.
We have, as in previous years, divided our report into two sec-
tions. One section is about money, and one is about work.
Fiscal Report p
The figures that follow are taken fiom the Balance Sheet, the Ex-
hibits and schedules ofthe Audit for the fiscal year which ended
April 30, 2001.

Certified Public Accountants I Business Advisors
mi., Place etlliig Bai 5...; M§.[s.. si}.; 33{ LQ;;;rZ,ifEtI55ii§Ae§;;s.i}6¤ F égiilos, MER .x..t.,.w CQ
To the Board of Governors
FNS, lnc. and Affiliates
Lexington. Kentucky
i We have audited the accompanying combined statements offinancial position of FNS, lnc. (a non-
profit organization) and affiliates as of April 30, 2001 and 2000, and the related combined statements
of activities and changes in net assets and cash flows for the years then ended. These combined
. Hnancial statements are the responsibility of the Service's management. Our responsibility is to
express an opinion on these combined financial statements based on our audits.
‘Ne conducted our audits in accordance with auditing standards generally accepted in the United
States ofAmerica. Those standards require that we plan and perform the audit to obtain reasonable
assurance about whether the combined financial statements are free of material misstatement. An
audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the
combined financial statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall financial statement
` presentation. We believe that our audits provide a reasonable basis for our opinion.
ln our opinion, the combined Hnancial statements referred to above present fairly, in all material
respects, the financial position of FNS, Inc. and affiliates as of April 30, 2001 and 2000, and the
changes in its net assets and its cash flows for the years then ended in conformity with accounting
principles generally accepted in the United States of America.
@1117,4, 4 (',0w(a/ug), LLP
July 13, 2001

April 30, 2001 and 2000
2001 2000
Current assets:
Cash and cash equivalents $ 1,240,195 $ 2,274,551
Patient, less allowances for uncollectible
accounts of approximately $2,021,000 and
$2,300,000 in 2001 and 2000, respectively 2,824,773 2,053,573
Student tuition, less allowances for uncollectible `
accounts of approximately $15,000 and
$31,000 in 2001 and 2000, respectively 170,450 396,095
Other 900 875,721
Investments 29,315,224 31,215,909
Inventories 260,116 353,303
Prepaid expenses and other assets 331,750 105,298
Total current assets 34,143,408 37,274,450
Property and equipment, net 2,470,509 2,923,403
Other assets:
Present value of beneficial interest
in outside trusts 1,899,853 2,105,670
Total assets $ 38,513,770 $ 42,303,523
See accompanying notes. 2   i·

Current liabilities:
Accounts payable $ 1,010,246 $ 772,725
Accrued salaries and withholdings 381,087 345,015
Accrued vacation expense 385,129 389,099
Deferred tuition, students 513,413 671,988
, Self-insured reserve 321,845 421,385
Estimated third-party payor settlements 458,639 569,535
~ Capital lease payable - current portion 94,712 120,550
Notes payable - current portion 15,879 8,237
Bond payable - current portion 105,919 100,808
` Other liabilities 628,558 456,862
Total current liabilities 3,915,437 3,866,215
Long term Iiabilites:
Capital lease payable, net of current portion 0 105,526
Notes payable, net of current portion 54,606 33,454
Bond payable, net of current portion 211,395 317,821
Total long term liabilities 256,001 457,801
Total liabilities 4,182,438 4,324,016
Net Assets:
Unrestricted 17,523,997 21,542,401
Temporarily restricted 10,988,460 12,524,914
Permanently restricted 5,818,875 3,812,192
Total net assets 34,331,332 37,979,507
, Total liabilities and net assets $ 38,513,770 $ 42,303,523
|! l· In
1 3 =

Years ended April 30, 2001 and 2000 ·`
LE.1 @9
Change in unrestricted net assets; *.
Revenues and gains:
Net patient service revenue $ 14,250,646 $ 14,908,338
Contributions 689,148 1,149,260
Education revenues:
Tuition and educational fees 1,562,281 1,361,157
Federal grants 113,786 170,650
Other grant revenue 79,944 60,000
Net realized and unrealized gain
on investments (2,836,403) 2,640,884
Other revenue:
Interest and dividend income 1,135,925 915,151
Other revenue 269,933 909,677
Total revenues and gains 15,265,260 22,115,117
Salaries and wages 7,988,893 8,040,134
Fringe benefits 1,429,429 1,306,051
Medical services, supplies, and
other expenses 6,852,130 6,002,091
Facility costs 1,718,572 1,687,981
Provider taxes 181,398 203,912
Provision for bad debts 1,113,242 793,624
Total expenses 19,283,664 18,033,793
Change in unrestricted net assets (4,018,404) 4,081,324
Change in temporarily restricted net assets:
Contributions 85,852 124,608
Change in annuity payable 34,165 0
Net realized and unrealized gain on investments (1,756,471) 2,018,632
Change in temporarily restricted net assets (1,636,454) 2,143,240
Change in pemwanently restricted net assets:
Contributions 2,212,500 25,318
Present value of beneficial interests
in outside trusts (205,817) 178,344
Change in permanently restricted net assets 2,006,683 203,662
Change in net assets (3,648,175) 6,428,226
Net assets, beginning of year 37,979,507 31,551,281
Net assets, end of year $ 34,331,332 $ 37,979,507
See accompanying notes. 4   "’
‘ I

" Years ended April 30, 2001 and 2000
209.1 2999
’· Cash flows from operating activities:
Change in net assets S (3,648,175) $ 6,428,226
Adjustments to reconcile changes in net assets
to net cash provided by operating activities:
Present value of beneticial interest
in outside trusts 205,817 (178,344)
Provision for bad debts 1,113,242 793,624
Depreciation 739,166 783,591
Net unrealized loss (gain) on investments 7,201,144 (2,722,882)
Contributions restricted for programs
and investments (2,212,500) (25,318)
(Increase) decrease in:
Patient receivables (1,884,442) (910,510)
Student tuition receivables 225,645 (168,815)
Other receivables 874,821 (25,528)
Inventories 93,187 60,230
Other assets (226,452) (17,046)
Increase (decrease) in:
Accounts payable 237,520 (725,073)
Deferred tuition, students (158,575) 428,313
Self-insurance reserve (99,540) (13,915)
Estimated third—party payor settlements (110,896) (185,606)
Other liabilities 193,808 (188,710)
Net cash provided by operating activities 2,543,770 3,332,237
Cash tlows from investing activities:
Purchase of property and equipment (286,272) (410,021)
Net purchase of investments (5,300,460) (1,928,858)
Net cash used in investing activities (5,586,732) (2,338,879)
Cash tlows from Hnancing activities:
Borrowings from notes payable 40,472 46,210
Payments on notes payable (11,679) (4,519)
Payments on capital leases (132,373) (124,433)
Payments on bond payable (100,314) (94,581)
Investment subject to program restrictions 2,212,500 25,318
Net cash provided by (used in)
tinancing activities 2,008,606 (152,005)
\= II)  
" See accompanying notes. 5 =

Years ended April 30, 2001 and 2000 `
2001 2000 I
Net increase (decrease) in cash and
cash equivalents (1,034,356) 841,353
Cash and cash equivalents, beginning of year 2,274,551 1,433,198
Cash and cash equivalents, end of year $ 1,240,195 $ 2,274,551
Supplemental cash flow information:
Cash payments for interest $ 47,547 $ 72,764
See accompanying notes. 6   I

, April 30, 2001 and 2000
' This summary of significant accounting policies of FNS, Inc. and Affiliates (the Service) is presented
to assist in understanding the Service’s financial statements. The financial statements and notes are
representations of the Service’s management who is responsible for their integrity and objectivity,
These accounting policies conform to accounting principles generally accepted in the United States of
America and have been consistently applied in the preparation of the financial statements.
Mary Breckinridge established Frontier Nursing Service in Leslie County, Kentucky, as the Kentucky
Committee for Mothers and Babies in 1925. The name later changed to Frontier Nursing Service in
1928. The Service’s original purpose was to provide needed health services in the Appalachian area,
introducing the first nurse-midwives in the United States. During its early years, the Service was the
only provider of health services in the area and it r