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 
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 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
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

_ 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
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.

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

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

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

  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
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

exploring the possibilities of medical research positions in Con-  
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 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.

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
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 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 -- _ •
c sem. 26 -2s   Q
_ L LONIION, KY I        
‘ ‘ ‘ for into. I-8IIO·348·0095 I " ` , 1
.     . ,.,_.   ....     ttts‘  

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

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

of the I,
for the Fiscal Year  
May 1, 1995 to April 30, 1996  
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.
We have, as ·in previous years, divided our report into two I
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 ofthe Audit for the fiscal year which ended
April 30, 1996. .

1. Report of Independent Auditors
[ 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
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
  6/vwof 1* MLLP
{ June 20, 1996

FNS, Inc. l
Combined Balance Sheets `
Aprn 30  
1996 1995 g
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

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.

FNS, Inc. 1
Combined Statements of Revenue and Expenses [
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
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 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
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  
See accompanying notes.

 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.  

 FNS, Inc.
Notes to Combined Financial Statements
April 30, 1996
1. Organization and Summary of Accounting Policies
  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.
,   Principles of Combination
  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
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