xt7wm32n7c9k https://exploreuk.uky.edu/dips/xt7wm32n7c9k/data/mets.xml The Frontier Nursing Service, Inc. 1996 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. 72, No. 1, Summer - September 1996 text Frontier Nursing Service, Vol. 72, No. 1, Summer - September 1996 1996 2014 true xt7wm32n7c9k section xt7wm32n7c9k FRONTIER NURSING SERVICE I J A Volume 72 Number l Summer — September 1996 5 E y { A Lad; XQ- SEVENTY-FIRST ANNUAL REPORT "°~· - " · ~ J J? · <é»» ' A is A1,_ ·~ »’r·’ .·-,, \ i " { Qi" N I :v_» Z. A. ` · vjwf I ` _ 5;} · I 3/ / M f , _·.WA r j ’ V `f€{‘¤;t_>; V °f.,g1 *-·°*`}};-» 4 _ l " q‘°‘t-_? T X-- A ·. ·· 72%;.; I T V_,_V _ _ ..;.{·.;_»i.,% rrerrre gg . T R I i;‘»_`_§x l gag » · V — - I ¢**'·*f`* . ` ‘··. :. ' :¤·‘,`•v,*· { J ~ V;. s? I I 1 ..4:-A V" / _ _ _ ~;%;;;; ·——·r · e r ~ v Y_Y. _ ei " ' I j " ._ ‘‘_` US ISSN 0016-2116 Table of Contents Field Notes - Susie Hudgins 1 ` The "Singing Class" Reunion - Elaine Douglas 3 Courier News - Dan Eldridge 5 · Dan leaves the "Nest" — Dan Eldridge 7 FSMFN/CNEP News — Phyllis Long 10 Audit Report - Ernst & Young 12 Report of Operations 30 In Memoriam/In Honor Of — Barb Gibson 35 Urgent Needs inside back cover Cover: Dan (Courier Coordinator) leaves the "Nest" (see page 7). Photos by Barb Gibson. Correction: The last issue of the Quarterly Bulletin — Volume 73, Number 4, should have been Spring, June 1996. This is the Summer issue. Frontier Nursing Service Quarterly Bulletin US ISSN 0016-2116 Published at the end of each quarter by the Frontier Nursing Service, Inc. Wendover, Kentucky 41775 Subscription Price S 5.00 a Year for Donors Subscription Price $12.00 a Year for Institutions ¤ Editor's Office, Wendover, Kentucky 41775 VOLUME 72 NUMBER 1 September Summer 1996 Sec0nd·c1ass postage paid at Wendover, KY 41775 and at additional mailing offices. ' POSTMASTER: Send address changes to Frontier Nursing Service, Wendover, KY 41775. Copyright Frontier Nursing Service, Inc.l996/A11 Rights Reserved 1 1 QUARTERLY BULLETIN 1 _ Field Notes Found! A limited number 0f c0pies of "Organdie and Mull" written by Mrs. Breckinridge, published in 1948. $6.00 o each. Cantact Susie Hudgins. ` In the last Quarterly Bulletin I reported that we expected to have the rewiring project in the Garden House finished in a couple of weeks. That tumed into a pipe dream with problems arising, illnesses among the staff, and various changes needing to be made along the way. But, through all the adversities, it is completed now. Everyone is delighted not only with safe wiring but how everything looks. One wonderful outcome in dropping the ceilings in the offices is that in being insulated so well, the couriers don't hear us in the early momings and we can barely hear them! Before, it was easy to hear a pin drop upstairs! Soon the maintenance crew will start rebuilding the stone wall behind the Big house - a job that sorely needs doing before it falls stone by stone into the kitchen. And, ofcourse, they have been busy trying to keep the grounds mowed, a never ending summer exercise. Wendover is delighted to welcome Lucy Napier to our staff part-time. She will be helping Cassie keep up with our I various functions as well as helping Christine with her housekeep- ing duties. In her first few days, Lucy has made tremendous progress organizing an overwhelming number of boxes of "Grab" (used clothing, etc.), work that Christine and I will be forever grateful for. Now, finally, we have hope of finding what we need , when we need it. Along the line we've had a busy social schedule. The first party was to say good-bye to Sister Sonia Miley, FNP atBeechfork ·’ Clinic. Sister Sonia came to FNS in the fall of 1990 and, after . almost six years, decided it was time to retum to Wisconsin. During her time here Sister Sonia gained the love and respect of all , who knew her. She will be spoken of often and sorely missed. ! 2 FRONTIER NURSING SERVICE Next came the FSMFN Class of 1961. What a wonderful time! Wendover thoroughly enjoyed "The Singing Class", and marveled at all their stories of being students here as well as where P their paths had taken them. We invited the Level III Class for dinner and the evening tumed to swapping school day stories, the _ past and present, each wondering how they did it (see article - page 3). We're hoping that more reunions will be held. Just give me a y call and we'll make it happen. I Habitat for Humanity held an all day seminar at the Big I House to swap ideas and to gain knowledge from each other. This was an incredible group of dedicated people from the Southeast ` region and over lunch we were all affected by their commitment and spirit. Sometimes one had to wonder how they kept going ‘ when so much seemed to be going against them but not a one was downhearted. Ido believe the Habitat people are the epitome ofthe saying, "where there is a will, there is a way." Kentucky Tech, from Somerset, Kentucky brought two tours in June. Then students from Morehead University spent a day with us for history and an in—depth midwifery lecture with midwife Marina Alguzary. We've had a number of students from the University of Kentucky stay at Wendover while completing the l clinical portion of their courses. i The calendar is filling up fast for the next few months. I Everyone is trying to fit vacation in now and get rested up for the l fall. —Susie Hudgins i Old Quarterly Bulletins available We still have some issues of Quarterly Bulletins available as far %_ back as the late l920's. Contact Susie Hudgins for copies (1.00 each). QUARTERLY BULLETIN 3 The "Singing Class" Reunion = On June 7, 1996 six of the seven in our Frontier Graduate School of Nurse Midwifery (FGSNM) class met at the Lexington ` airport and drove to Hyden and Wendover to celebrate our 35th class reunion. We graduated in May 1961 and over the years we Q kept in touch on three continents by a "Round Robin" letter which is still circulating. We spent six wonderful and busy months at FNS from · December 1960 to May 1961 studying nurse-midwifery and preparing ourselves for overseas service. Some of the class had I already spent several years in missionary service in Africa. While E we were studying and delivering babies, we also enjoyed mutual interests and had great times of fellowship. We loved to sing, and I Martha and I took turns playing the piano for good harmonizing. j We probably had five different parts from low bass to high E soprano. Thus we were called the "Singing Class". j We also had nicknames. Jewell Olson was naturally called, "Gem" and she served many years in missionary service in Zaire (formerly Belgian Congo), before and after our FNS time. Mary Nell Harper worked many years in Ethiopia and "Full One" was a translation of her Ethiopian name: she had a hearty and full I laugh! Jody LeVahn is still presently serving in Zaire, and she was I the only one not able to be at our reunion. As we reminisced, at our reunion, the only nickname we came up with for her was just "Jody". Martha Lady was, indeed, a lady, and her name just got tumed around to "Lady Martha". She served many years in Rhodesia (now Zimbabwe). j. The remaining three of us had missionary service ahead of us. Betty Mantay came from Canada, and because she was the youngest, her name was "Least One". She worked in the Cameroons, ~ in West Africa, and, presently after doing some French study in Quebec, will be returning there for yet another term of service. Helen Traschel Potter was the only one of us to be married, and 1 also to work in the South American continent in Bolivia. We called Q her "Third-Stage—Traschel" because she seemed to always be late 4 FRONTIER NURSING SERVICE l for delivery but got there for the third stage! I (Elaine Douglas) was known as "Granny"! I was always cold and often wrapped myself if up in a shawl, sat in a rocking chair in front of the fireplace (with Ei a fire) and ate popcom. It was my privilege to do missionary service in Eritrea, previously the northem province of Ethiopia, now the newest independent country in Africa. Jewell and Mary Nell are now retired, living respectively § in Nebraska and Washington and are active in various church and community volunteer activities. Martha is a chaplain in a retire- ment village in Pennsylvania. Helen and her husband, Harry, are working with a Spanish-speaking church and working in health g agencies in Florida. I am also in Florida, on home staff with my mission, serving as head nurse at our mission retirement village. Jody and Betty continue their missionary work in Africa. ‘ Our reunion in Wendover and Hyden was a wonderful time of renewal, a time of singing, and praying together. It was just great to see the old places, even though much changed in opera- tion, yet still greatly serving the people of Kentucky and training nurse-midwives. The program has changed tremendously since we were there, but we were happy to be there at the "right time" to meet a dozen ofthe current students, who had come for a two week period of study. We especially appreciated the help and friendli- ness of Susie Hudgins who helped with the arrangements for our reunion through phone calls and correspondence. It was a blessing to look again at the portrait of Mrs. Mary Breckinridge, whom we had known, and to remember the great good she did in her life for _ the people of Leslie County, and around the world. » All of us benefited so much from our training at FNS and we were so thankful many times on the mission field for what we ; had learned. We were able to share many of those amazing " incidents with one another at our reunion. Even though we were in . Hyden six short months, they had a great impact on our lives, not _ only in our midwifery work, but also in the friendship which has , endured these many years. Our shared love of the Lord, for I missions, for music, and for people in Kentucky and overseas has . drawn and kept us together. And it all started at FNS! Thanks! V. —Elaine Douglas A l QUARTERLY BULLETIN 5 Courier News The summer months in Leslie County are truly a wonder- Q ful time. With the warm weather and longer days comes a never ending flow of "extracurricular" activities that seems to keep us l busy around the clock. Baseball games, Blue Grass festivals, E cookouts and the opening of the pool all are tempting distractions from the regular day. Even so, Couriers have somehow managed to squeeze all of these things (and more) into their already busy Courier routine. Couriers have seen a number of births, observed hours of operations and destapled a never ending flow of account- ing papers. This summer group has truly made the most of their time in Hyden, as I am sure past Couriers can relate to. · Past Couriers Emily Davis (‘92) Coordinator ‘95, recently returned to New York after spending a year with us here at Wendover. Reports are that she has not suffered too badly from urban re-entry shock, but that she does miss Wendover. Wendover also misses her. Rosie Perea ('94) called up a while ago from Colorado where she is spending her Junior year. She is planning on running around the mountains and enjoying the scenery while studying geology and geography. Krista Nickerson ('95) sent us a colorful card to tell us ‘ that she has been accepted into the Peace Corps. She has been assigned as a Community Health Extension agent for the Ministry of Health of Chad in Central Africa for the next two years. She is ; hoping to work with a whole cross section of health care profes- 'A sionals and possibly lay midwives. . Catie Fisher ('95) sent us a note to bring us up to date on _ the events of her life. She has decided not to go into medicine and instead she is likely going to major in photography with a minor in environmental science. , Mitch McClure ('95) checked in with us and brought us s up to date on his life. He has graduated from Harvard and is now 6 FRONTIER NURSING SERVICE { exploring the possibilities of medical research positions in Con- necticut. Jen Galvin ('95) dropped us a note to say that she has if safely retumed from working in Florida at a marine institute. She is still debating whether or not to apply to medical school and she might have to go "find herself’ on the West coast. 1 Bhavin Mehta ('95&"96) phoned up a while ago and told i us that he had been accepted to the New York School of Podiatry Medicine. Bhavin seems to be looking forward to the next few years in New York where he is planing to meet Elle McPhearson. Tarah Sommers ('96) contacted us just before her depar- ture for Turkey and Turkmanistan. She sounded a little apprehen- sive about the whole trip but we are sure that she will do very well. We wish her a wonderful trip and a safe retum. The Summer Br00d Liz Tartell, 21, arrived at Wendover from Bayside, New York, earlier this summer. Since then, she has quickly befriended many in and around FNS. Liz spent a great deal of time with Thumper who has been in and out of the hospital for months now. While at FNS Liz was able to observe two births and was able to gain a better understanding about many of the issues conceming rural medicine. Barrett Giffel, 22, came to us from East Stroudsburg, Pennsylvania and has quickly enmeshed himself in the commu- ’ nity. Barrett is a frequent fan of the softball games in Hyden. He has spent time all over FNS with particular interest in Wooton Clinic and the operating room. Barrett graduated from Penn State Q and is planning to enter medical school next year after furthering i his experience in the health care field. " Leslie Bardo, 19, arrived at Wendover in her "Lobster Pod" from Wilton, Maine and soon felt at home in the county that bears her name. Leslie has had a long interest in medicine and she I has been busy in all the various facets of FNS. She has spent a great deal of time with Betsy MacMillan, CNM and wandered around the countryside with the home health nurses. In her spare time A Leslie has been training for a marathon and quilting. She will be » retuming to St. Olafs College in the fall. . i QUARTERLY BULLETIN 7 I Heather Wadell, 22, came to Wendover from Grand { Rapids, Michigan after graduating from Harvard this spring. She plans to study public health at the University of Michigan and I decided to spend the summer as a Courier in order to get a jump start on her formal studies. Heather has spent a lot of time around FNS with people like Jana Cuddy , PA, in the Hyden Clinic, and running around in her little white car. In her spare time Heather has been hard at work on her quilt which is sure to keep her warm through those cold Michigan winters. ``·· A ‘ wg . ' i= f V. _, {g i _.A§~§gl¢¥ { _,ssu“m,., 3 a Dan leaves the "Nest" i Over the course of my time here at Wendover I have discovered thatI share a cosmic link with Mrs. Breckinridge. Now [ some may take offense to this notion, and still others may grow green with envy as they wend their way through the world of _ midwifery, but I have taken this bond as a sign of comfort and security while calling Wendover my home. I am not talking here of links relating to children, or one that would drive me to become a midhusband, but rather my link is of a personal nature that delves p deep into the realm of poultry. I 8 FRONTIER NURSING SERVICE It is common knowledge that Mrs. Breckinridge had a i particular fondness for our friendly handicapped birds. Thumper and Alabam have often told the stories of Mrs. Breckinridge gathering up the scraps from the dinner table and going out to commune with her flock. There have also been the various i. escapades, such as Operation Cluck Cluck, that are waiting in the wings for Thumper’s sequel to Where else but here?. But the l constant theme here is Mrs. Breckinridge’s love for the lowly chicken. Now, while I have p *’ ' ns not been completely con- p scious of the fact, I too ¥• r 3 V. V have consulted with some i }’·» chickens on important is- -1% Qi , sues in my life. In fact, _ ,. -v-¤» ~ since leaving university I g » xix have always kepta chick- I ‘ V . en loyally at my side. He has often been called on g to offer tidbits of advice . in my moments of need. ·e * x These have helped to I ( I .2 ~, _, “ Ewa pi - guide me through the ever _ _ p A l . changing cosmos that we ' so often find ourselves V ,-.`a Z _ . adrift in. . A I A . Mrs. Breckinridge i There is, however, a subtle difference in our mutual love for chickens. While Mrs. Breckinridge prefered the real McCoy i I have chosen the imminently more practical petrochemical by- ‘ product. Yes, Rubber Chickens are somewhat less graceful, but few can contest the fact that they are infinitely more practical when ,_ negotiating customs in a foreign country. As I now leave Wendover for a second time with my _ rubber chicken, I also take with me a long list of experiences. The Couriers and the staff of Wendover have been a constant source of I QUARTERLY BULLETIN 9 I I introspection and challenge. These experiences have set many I benchmarks to judge the world by. The friends I have made here f' have shown me that Kentucky is full of intrigue and wonder, as I well as love and kindness. I will reflect on all of these in a time of need. We are not only a product, but also our experiences in life. My time at Wendover has certainly made me a better person. I While it is fun to theorize about what Mrs. Breckinridge would be doing right now if she were still with us, there are a few things that she would surely be doing. She would be attending to the needs of her chickens and their human counterparts (maybe not in that particular order). To me this is what made Mrs. Breckinridge great, and can still evoke such fond words and admiration from all those who knew her. From what I understand, it was her empathy for the individual, integrity and dedication to her mission that elevated her above the flock. It was her willingness to listen and her ability to give that created a following that still draws people to witness her achievements. While with FNS I have grown to know so many wonderful people. I have realized that they all are the most important part of FNS with their dreams and ideas making FNS what it is today. This I will take with me to Rubber Chicken Heaven. Long live the Chickens! I! -Dan Eldridge 1996 INIIIILII -- _ • ’ CHICKEN FESTIVAL ` ·’ c sem. 26 -2s Q _ L LONIION, KY I ‘ ‘ ‘ for into. I-8IIO·348·0095 I " ` , 1 . . ,.,_. .... ttts‘ IO FRONTIER NURSING SERVICE j FSMFN/CNEP News 1 End of summer means "back {___ to school" everywhere. So, at CNEP ` il ’``’ we are gathered in Hyden for another I I Midwifery Bound session to wel- Class 17. From all over the country, ' -»*. U new students arrive at the Hyden I M; ` is I ,__} __;_V _: campus in time for supper on Wed- ____;_ _ - nesday. Most begin this trip by air, I I I coming into Bluegrass Field in Lex- ij l``" g L I ington to find Debbie Comett at the Phyllis L0ng welcome center. The yellow school bus leaves Lexington loaded with students, accompanied by Kitty Emst who makes sure they all know the CNEP song by the time they reach Hyden. I On arrival the students receive a CNEP book bag loaded with the Level I modules and materials. Thus begins an evening of getting to know classmates and looking over the preview to their joumey to midwifery. Small groups, based on geographic loca- tions, allow students to meet those who may live near enough for easy get—togethers or seeing one another at future case days. Fil ` _, j g§1’f,':£¤"‘:*=p ¤ lg; t _i; ‘ /·$?j#J—1g. `I gg; T J A I L if lI¤ I I I I IIII I ’ V if MT I r ”'=i tf #3 * I Lil 1 Midwifery Bound students I QUARTERLY BULLETIN l 1 l The next three days go by in a whirl of activity. Students i meet the staff of the Hyden Office and our Financial Aid Officer. i' They have photos made, learn their way around the School, and [ have a chance to shop for local crafts. The Level I faculty present an overview of each course and provide an opportunity to get I started on a learning activity. Students are interviewed by a , Student Advisor and start working on their individual planning for y success in the Program. An important part of the Midwifery Bound experience is the chance to develop skills and confidence in using the Banyan Tree, our electronic bulletin board. Class 17 includes students from all over the United States, including Hawaii and one person from Canada. lt takes at least a day to get to Hyden from most locations. Is Midwifery Bound worth the time and expense? I believe the few days in Hyden provide our students with a sense of the Frontier School of Midwifery and Family Nursing's contribution to the history of nurse-midwifery education in the United States. There is value in I developing an identity with all the CNM`s who have gone from . Hyden to the wide neighborhoods of the world. The bonding with fellow students and faculty means the beginning of a network of , strength and support for the intense journey ahead. Distance leaming depends on this network of support and communication. ` So, in another four weeks, we'll be back to welcome Class 18 as CNEP continues to work toward the goal of 10,000 nurse- 0 midwives by 2001. —P/iyllis Long, Interim Program Director 12 FRONTIER NURSING SERVICE I SEVENTY-FIRST ANNUAL REPORT of the I, FRONTIER NURSING SERVICE, INC. Q for the Fiscal Year May 1, 1995 to April 30, 1996 I I PREFACE As has been our custom since we were one year old, we present our annual report of the fiscal affairs and of the field operations of the Frontier Nursing Service, Incorporated. I I We have, as ·in previous years, divided our report into two I sections. One section is about money, and one is about work. . FISCAL REPORT The figures that follow are taken from the Balance Sheet, the Exhibits and Schedules ofthe Audit for the fiscal year which ended April 30, 1996. . n i I 1 i 1 *1 l 1. Report of Independent Auditors 1 [ Board of Govemors FNS, Inc. i We have audited the accompanying combined balance sheets of FNS, Inc. and affiliates » (as listed in Note 1) as of April 30, 1996 and 1995, and the related combined statements of revenue and expenses, changes in net assets and cash flows for the years then ended. These financial statements are the responsibility of FNS, Inc.'s management. Our responsibility is to express an opinion on these financial statements based on our audits. { We conducted our audits in accordance with generally accepted auditing standards. Those 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 examining, on a test basis, evidence supporting the amounts and disclosures in the 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. In our opinion, the financial statements referred to above present fairly, in all material respects, the combined financial position of FNS, Inc. and affiliates at April 30, 1996 and 1995, and the combined results of their operations, changes in their net assets and their _ cash flows for the years then ended in confonnity with generally accepted accounting principles. 6/vwof 1* MLLP { June 20, 1996 ‘ l I FNS, Inc. l Combined Balance Sheets ` Aprn 30 1996 1995 g L. Assets i Current assets: Cash and cash equivalents $ 1,646,526 $ 1,712,676 Accounts receivable—patients-less allowances for uncollectible accounts of $817,000 in 1996 and $613,000 in 1995 2,652,472 1,758,499 Accounts receivable—students tuition 1,513,588 1,001,154 Inventories 356,746 203,840 Prepaid expenses and other current assets 342,805 907,390 Total current assets 6,512,137 5,583,559 Student loan receivables 48,376 59,875 Long-term portion of accounts receivable-students tuition 442,119 443,551 Property and equipment: Land 177,062 141,137 A Buildings 3,708,368 3,642,474 , Equipment 5,159,994 4,798,801 Construction in progress 544,260 29,895 ‘ 9,589,684 8,612,307 l Less accumulated depreciation 6,622,678 6,272,805 · 2,967,006 2,339,502 Assets whose use is limited 14,021,141 12,416,605 Present value of beneficial interest in outside trusts 489,000 - 4 Total assets $ 24,479,779 $ 20,843,092 l `B 1 1 1 I if April 30 1 1996 1995 i' Liabilities and net assets I Current liabilities: Accounts payable S 1,487,301 $ 1,216,497 Accrued salaries and withholdings 298,744 219,089 Accrued vacation expense 384,761 335,489 Deferred tuition—students . 2,254,588 1,563,615 Unexpended special purpose funds 225,369 162,956 Payable to third-party programs 243,170 200,624 Other current liabilities 1,082,870 1,005,157 Total current liabilities 5,976,803 4,703,427 Gift annuity reserve 39,481 - Long-term portion of deferred tuition-students 442,119 443,551 1 Contingencies Net assets: ` Unrestricted 14,508,224 13,021,722 V Temporarily restricted 1,028,361 - , Permanently restricted 2,484,791 2,674,392 Total net assets 18,021,376 15,696,114 ~ Total liabilities and net assets S 24,479,779 $ 20,843,092 f Sec accompanying notes. `1 a 1 1 1 FNS, Inc. 1 Combined Statements of Revenue and Expenses [ 1 Year ended April 30 1996 1995 é Unrestricted net patient service revenue $ 14,933,197 $ 13,188,576 P Education revenues: { Tuition and educational fees 2,447,938 2,323,677 l Federal grants 282,751 297,386 1 2,730,689 2,621,063 I Other revenue 306,352 267,571 ; Unrestricted donations 782,889 804,979 _ Total revenue 18,753,127 16,882,189 Expenses: Salaries and wages 8,690,360 7,821,024 Fringe benefits 1,547,162 1,394,010 Medical services, supplies and other expenses 5,525,288 4,747,794 Facility costs 1,285,412 1,373,880 Provider taxes 265,676 273,647 Provision for bad debts 1,067,819 754,731 Total expenses 18,381,717 16,365,086 I Income from operations 371,410 517,103 Nonoperating gains: Investment income 604,839 413,746 Gain on sale of investments 243,708 248,033 848,547 661,779 Excess of unrestricted revenue and gains over expenses $ 1,219,957 $ 1,178,882 See accompanying notes. V l l l l l l FNS, 1nc. E Combined Statements of Changes in Net Assets i Temporarily Permanently 1* Unrestrictd Net Restricted Net Restricted Net Asset Assets Assets Total Balances at April 30, 1994 S 11,702,799 S — $ 2.542,152 S 14,244,951 fr 1 Excess ofunrestricted revenue and gains l over expenses 1,178,882 - 4 - 1,178,882 l Restricted contributions used for purchase of 1 property and equipment · 140,041 - . 140.041 l Contributions restricted for specific purpose - - 33,807 33.807 i Gain on sale ofendoxwnent fund investments - - 98,433 98,433 I Balances at April 30, 1995 13,021,722 · 2,674.392 15,696.114 l Cumulative effect of adoption of 1 FAS No.116and117; Reclassification to temporarily restricted - 686,781 (686,781) » I Present value ofbeneficial interest in ' outside trusts - 450,000 450,000 Excess ofunrestricted revenue and gains over expenses 1,219,957 - — 1,219,957 Change in value of beneficial interests in outside trusts — - 39,000 39,000 Restricted contributions used f`or purchase of property and equipment 266,545 - · 266,545 Contributions restricted for specific purpose - 76,344 8,180 84,524 Gain on sale ofendowment f'i.tnd investments - 265,236 ~ 265,236 Balances at April 30. tm I See accompanying notes. r FNS, Inc. Combined Statements of Cash Flows Year ended April 30 1996 1995 Cash flow from operating activities and gains l Excess of unrestricted revenue and gains over expenses S 1,219,957 $ 1,178,882 i Other changes in net assets 1,105,305 272,281 i Increase in net assets 2,325,262 1,451,163 y Adjustments to reconcile increases in net assets to net cash V provided by operating activities and gains: i Cumulative effect of adoption of FAS No. 116 and 117 (450,000) — Increase in net present value of beneficial trusts (39,000) — i Provision for bad debts 1,067,819 754,731 i Depreciation 370,082 405,987 Gains on sale of equipment (2,418) (17,683) { Accounts receivable-patients (1,961,792) (759,304) { Accounts receivable—students tuition (511,002) 527,872 Other assets 423,178 (232,296) Accounts payable 270,804 72,467 Payable to third party programs 42,546 233,624 Deferred tuition-students 689,541 (138,508) Other 308,533 153,378 ; Net cash provided by operating activities and gains 2,533,553 2,451,431 Cash flows from investing activities i Purchases of property and equipment (1,006,033) (498,034) ‘ Proceeds from sale of equipment 10,866 32,973 i Cash invested in assets whose use is limited (1,604,536) (981,197) Net cash used in investing activities (2,599,703) (1,446,258) i Net (decrease) increase in cash and cash equivalents (66,150) 1,005,173 Cash and cash equivalents at beginning of year 1,712,676 707,503 l Cash and cash equivalents at end of year S 1,646,526 $1,712,676 1, See accompanying notes. I FNS, Inc. Notes to Combined Financial Statements April 30, 1996 1. Organization and Summary of Accounting Policies Organization FNS, Inc. (the Service) was organized in 1925 as a nonprofit charitable organization. The " I Service's original purpose was to provide needed health services in the Appalachian area. During its early years, the Service was the only provider of health services in the area and ‘ it remains the largest provider of health services in Leslie County and the portion of § surrounding counties comprising its service area. In 1939, the Service established a i midwifery school. The Service currently operates an accredited midwifery and family I nursing school, a home health agency, a hospital, and provides primary care services i through the Hyden Clinic, the Kate Ireland Women's Health Care Center, and District , , Nursing Clinics. The Service has historically been dependent on charitable contributions , g to fund a significant portion of the costs of services and programs. I , Principles of Combination I The Service consists of the following nonprofit entities: > i I FNS. Inc.—Parent holding company ofthe Service. Mag; Breckinridge Healthcare, Inc.-Entity responsible for operating the hospital, i home health agency and clinics. l Frontier School of Mrdwrfeg and Family Nursing, Inc.-Entity responsible for ) operating the midwifery and family nursing school. L l Frontier Nursing Service Foundation, Inc.-Entity responsible for maintaining the l investment portfolio of the Service. - FNS Real Estate, Inc.-Entity responsible for holding and managing the real estate and = fixed assets owned by the Service. I The combined financial statements include the accounts and transactions of the above V entities. Significant intercompany transactions and accounts have been eliminated in [ combination. FNS, lnc. Notes to Combined Financial Statements (continued) 1. Organization and Summary of Accounting Policies (continued) Basis of Presentation I. During 1996, FNS adopted Financial Accounting Standard (FAS) No. 116, Accounting for Contributions Received and Contributions Made and FAS No. 117, Financial Statements of Notfor-Profit Organizations. FAS No. 116 establishes standards of financial accounting and reporting for contributions by requiring that contributions be recorded at fair value in the period received or pledged. Donor-restricted contributions are reported as either temporarily or pennanently restricted support if they are received with donor stipulations that limit the use of the donated assets. When a donor restriction expires, that is, when the purpose of the restriction is accomplished, temporarily restricted net assets are reclassified as unrestricted net assets and reported in the combined statement of revenues and expenses along with unrestricted contributions as donations and bequests. Donor-restricted contributions whose restrictions are met within the same year as received are accounted for as unrestricted contributions. FNS elected to adopt FAS No. 1 16 through a cumulative effect adjustment which is reflected in the State