Another FORBA Insurance Company Does Not Want To Pay Up - No Big Surprise Here

FORBA Holding and its parent company, Small Smiles Holding seem to be having a magnitude of problems getting their insurance companies to pay up and/or continue coverage.  I am just taking a wild guess here but I think that might get much worse in the future.

Imagine the liability and increase in risk when clinic fully implement the sedation of children, either at a local hospital, surgery center, and in some cases, in house!!!!!!!!!!  Please see Meet The Dead Children On the Right.

Today FORBA filed a lawsuit against Zurich:  See It Here

On January 15, 2010, FORBA signed a settlement agreement with the United States Department of Justice and OIG-HHS whereby FORBA agreed to make a structured settlement payment of $14,285,644.75 (plus interest) to the United States, in exchange for a release of claims against it, its current officers and directors, its parents, subsidiaries, and affiliates, and the Small Smiles Dental Centers arising from the alleged wrongful conduct. 

FORBA also agreed to pay attorneys’ fees in the aggregate amount of $182,183.52 to three relators that filed qui tam actions alleging wrongful acts on the part of FORBA, as well as other defendants.

Pursuant to settlement agreements with each of the states and the District of Columbia, FORBA agreed to pay the aggregate amount of $9,714,355.25 (plus interest) to Alabama, Arizona, Colorado, Connecticut, District of Columbia, Georgia, Idaho, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Nebraska, Nevada, New Hampshire, New Mexico, New York, Ohio, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas, and Virginia in exchange for a release of claims against it, its current officers and directors, its parents, subsidiaries, and affiliates, and the Small Smiles Dental Centers arising from the alleged wrongful conduct.

Payment of $24 million is chump change to protect its current officers and directors, keep them out of jail.  In addition to keeping their families all nice and cozy in their elabrate homes and jet setting lifestyles. 

Since the agreement was signed and the token pledge of the Corporate Integrity Agreement, FORBA has managed to bill medicaid over $131 million in the last 10 months. 

FORBA states in the lawsuit they informed Zurich in November 2007, while the policy was in force, about the investigation and costs involved in defending themselves.  Zurch says too bad, you did not get a draft settlement until August 2009, so you are on your own.

I'm no genius, but does there seem to be a pattern emerging here?  No insurance company wants to cover FORBA,  Small Smiles Clinics, Small Smiles dentists and other employees for all their misdeeds. The ones that have hung on,  are doing so "eyes wide open" and most likely "rates sky high".

I am concerned FORBA and Small Smiles Holding have failed to inform their insurance companies of the hundreds of lawsuits in the works against, the clinics, the dentists, the staff, the directors, the officers down to the cleaning lady.  Ok, that was a lie, I'm not concerned one bit!

To you those dentists who have been fool enough to lend your name to FORBA so they can use you as an "owner", you may be in the worst shape of all.  You would be wise to storm the FORBA offices and demand your rubber stamps back and your names removed from all legal filings, and do so before the shredder gets fired up. 

 Do any of you have any idea all the documents they file a year with your name stamped all over it?

Dr. Jodi Kuhn

Dr. Olivia Croom

Dr. Helen K. Petersen

Dr. William Nash

Dr. Monica Switzer

Dr. Mark Toncini

Dr. Victoria Fletcher-Barnes

Dr. Medrina Gilliam

Dr. Gloria King

Dr. Latanya Gallon

Dr. Kevin Kingry

Dr. Karen Chu-Gongora

Dr. Randy Ellis 

Dr. Bonnie Mora

Dr. Toni Adderly

Dr. Daniel Spears

Dr. Todd Bjur

Dr. Zane Plamer

Dr. Ken Knott

Dr. Robert Andrus

American Securities - It's All In The Kool Smiles

Here is one you just have to love.  This person is on Twitter.

Says he works at Kool Smiles.  Says he currently lives in Louisville, Kentucky.  See here

Why am I afraid it's the one in the middle who will put his hands in a child's mouth tomorrow!

This is what American Securities wants to give $700 million to own.

 Update:
June 30,2011

American Securities appears to have backed out of this purchase of NCDR, LLC and it's string of Kool Smiles dental centers.

Kool Smiles Vancouver, Washington Complaint

Why on earth Private Equity Firm- American Securities-would even consider contaminating themselves by purchases these shit hole clinics is beyond me.  They must be sadistic bastards is all I can think of, and enjoy torturing America’s low income children.   I would call the review below "glowing” and the child lucky.  After all they didn’t leave with bruises and permanent emotional trauma as most children.  Friedman Fleischer & Lowe are trying to unload these before they go down like ENRON. 

I was just told this week, they had cut staff to the bare minimum to increase the profits getting ready for the big “sale”.   In my opinion, until the staff is cut to zero there are too many employed.

Here is a review from today!

October 25, 2010

I was very excited to take my son to this dental office. The website makes it look so fun and kid centered. From the moment I walked in I did not have a good feeling about it. This was confirmed once we were taken to the dental work room. It was a room with 8 dental chairs all together. The Dr came out to talk with us. He didn't shake my hand or introduce himself to my son or even ask my name. I don't even think he smiled. The other dentists/hygienists were talking badly about one of the other dentist/hygienists every time she would leave the room. There were two other young boys laying back in the chairs and no one was paying any attention to them or talking to them at all. For a business that markets themselves as kid friendly, they really failed at being friendly at all! We sat around for 20 minutes being ignored after the doctor did his exam, just waiting for the fluoride. We're all in the same room and they just ignored us. No one treated my son as a patient or gave him any attention. Then....the only prizes they had for my 5 year old was a rubber lizard or a broken pair of sun glasses. Oh fun. Made my other son an appt elsewhere. We will not be returning.

Unacceptable? You decide

Unacceptable Dental Practices in 2010

1. 1 Dentist seeing an average of 32 patients a day – That is an average of 4 minutes per child.  Same dentist strapped down 100 children and put on 1000 Stainless Steal Crowns.  I bet this dentist did a fine job!  Why is this person not in jail?
2. 1 Clinic (of three dentists) strapping down over 700 children in 88 days – That is almost 7 children papoosed a day in one clinic.  A clinic papoosing 540 is 88 days is not any better, nor is a clinic who papooses 450 in those same 88 days.
3. 1 Dentist tying almost 300 hundred children in 88 days is also unacceptable - That's an average of three a day for 1 dentist.  If I tied up 1 child in 88 days I would be in jail.
4. 17 Dentists all tying up children more than 100 times in 88 days.
5. 1 Child receiving  13 Stainless Steel Crowns, 11 Pulpotomies and 2 fillings in one OR visit.
6. 1 Clinic of 3 dentist clinic strapping down 160 children in 20 days.
7. Approximately 210 dentists doing 7 or more pulpotomies and putting on 7 or more stainless steal crowns on 400 children in 88 days.
8. 200 dentists pulling over 6 teeth at one visit on 100 children in 88 days.
9. One clinic of three dentists seeing 900 patients in one 5 day work week.  - That is 900 patients in 120 hours.  That is an average of 7 minutes per child.
10. No wonder 1000 treatments had to be redone in 88 days, putting children through hell double time.

It should be no surprise many office staff do not know the difference between "filling" and "feeling".
I know I am missing many other outrageous dental practices that have taken place in 2010 but these are on my mind at the present time.

In My Opinion These Are The Top 15 Small Smiles Clinics A Child Is Most Likely To Be Strapped In A Papoose Board

Just an educated guess based on several factors, including parent complaints:

1. Dothan, Alabama
2. South Bend, Indiana
3. Macon, Georgia
4. Savannah, Georgia
5. Youngstown, Ohio
6. Atlanta, Georgia
7. Akron, Ohio
8. Roanoke, Virginia
9. Florence, South Carolina
10. Beaumont, Texas
11. Worchester, Massachusetts
12. Albuquerque, New Mexico
13. Kansas City, Kansas
14. Montgomery, Alabama
15. Oklahoma City, Oklahoma

In 2010, I think Albany, New York (shocker) and Louisville, Kentucky are the clinics your child is the least likely to be tied up in that straight jacket type device.  Not that I recommend ANY of these dental mills! 

Assistant Attorney General Tony West Mentions Small Smiles Fraud and Patient Abuse In Yet Another Speech

October 20, 2010

Assistant AG Tony West delivered the Keynote Address to the Pharmaceutical Regulatory and Compliance Congress and Best Practices Forum today at the Marriott Hotel in Washington, DC.

Read his full statement here

Excerpts:

Since January 2009, we’ve commenced more health care fraud investigations, secured larger fines and judgments, and recovered more taxpayer dollars lost to health care fraud than in any other two-year period.  During that period, our civil fraud attorneys in the Civil Division have used the False Claims Act – a powerful tool that provides for treble damages – to recover about $4.2 billion lost to fraud against government health care programs…

 

…strongly encouraged Civil Division and United States Attorneys throughout the country to be appropriately aggressive in their use of the wide array of affirmative civil enforcement tools at their disposal.  Tools like Civil Investigative Demands, or “CIDs,” which allow law enforcement to speed up civil investigations by obtaining documents and testimony quickly and under oath.  The authority to issue CIDs once rested only with the Attorney General, but amendments to the False Claims Act last year allowed the Attorney General to delegate that authority to me as the Assistant Attorney General for the Civil Division.  I, in turn, have re-delegated much of that authority to U.S. Attorneys around the country so that they will be able to use this powerful investigative tool properly and effectively…

…And then there are those cases we pursue because they cut to the core of protecting both patient safety and the integrity of our public health care programs.  Cases like Small Smiles.  You may have heard about this case.  It involved a nationwide network of dental clinics that provided unnecessary dental services to needy children on Medicaid in order to maximize the company’s Medicaid reimbursements…

…And the stories we learned about during the course of our investigation were horrific:  unnecessary tooth extractions performed on children where healthy teeth were pulled; unnecessary dental surgery such as needless crowns; and excessive baby root canals – one child had 16 root canals in a one sitting…

In that case we not only obtained a $24 million settlement, but more importantly, important reforms to Small Smiles’ practices under new management, as well as the company’s cooperation in our ongoing investigation into individual dentists..

That last point—working cooperatively with companies—is an important one.   To be clear, no company is required to cooperate in the context of a civil or criminal case.  Yet when a company acts responsibly by timely and voluntarily disclosing unlawful conduct, it is the case that the Department may consider such cooperation in deciding whether or how to charge a corporation or to resolve a case, and indeed, it has been my practice to encourage that in appropriate cases.  In addition, when a company cooperates fully with an investigation, the Civil Division typically informs the HHS Inspector General’s office about the assistance the company provided…

It almost sounds like FORBA's Small Smiles clinics are getting a big pat on the back doesn't it.  Since they are "working cooperatively" and all.  They are still using the BIOB (Blame It On Bush) excuse saying all these terrible things happened with the DeRose family owned the clinics.  Never mentioning that one of their top VP's was with the company while under DeRose rule since 2003! 

I bet if they really took a look at the practices of the company just in 2010 they would find 'shocking' things still happening.

As recently as October 5th (yes, 15 days ago) one child received 12 stainless steel crowns 3 fillings and 11 pulopotomies all in one session.  Mom outraged.

On the same day another child received 3 fillings, 3 pulpotomies, 1 seal, 1 extraction and 5 stainless steel crowns. 

The very next day on parent was told their child needed 8 stainless steel crowns and wanted to do them asap.

Looking Like A Fool With Your Pants On The Ground II

That what you will be if you take a job with these dental mills.  Stay away.  Keep your dignity. 

New Small Smiles Clinics Opening Soon:

Muncie Indiana

Washington DC II

Mission, Texas

Don’t bee fool enough to sign any contract and commit yourself for years with any of these dental mills. 

Ad are out all over the Internet looking for employees.  Do Not be a fool.  Don’t do it.

I’m wondering what foolish insurance company is covering these clinics and the dentists and other professionals in them. 

Clinic’s Ownership: Tax Questions

No doubt I have asked this question before.  But I am going to ask it again. 
Since FORBA’s Small Smiles clinics are registered with the Secretary of State’s office as being owned by random dentists I have a few questions:

1.  Does the individual dentist file a tax return on those clinics?  If not, YIKES!
2. Does the individual dentist file a tangible property tax return and pay property tax on all that equipment?  If not, YIKES!
3.  When the dentist in question quits , gets fired or leaves FORBA’s employment, and FORBA is forced to register someone else as owner, how is this “sale” explained?   I’m thinking some major tax revenue is being missed here. 
4.  Why am I the only person asking these questions?
If Dr. Katie (Helen Petersen) does NOT own all those clinics in Indiana, what does Dr. Katie own?  What about Dr. Jodi Kuhn in Kentucky?  What about Dr. Ken Knott in Alabama?  (yes, Dr. Knott is still listed as owner in Alabama, or at least he was on December 31, 2009, because he signed (or someone signed) the annual report. What about Dr. William Nash? 
5.  I wonder if Dr. Ken Knott knows they still have him owning those clinics? 
If any of these dentist have not filed tax returns on the income from these clinics, I’d say there might be a problem.
How would this all be explained in an IRS audit?

Who knows, maybe all those tax forms are sent to Corporate Headquarters in downtown Nashville and someone down there files the tax returns and signs the name of the poor innocent dentists. 

Kool Smiles Said to Have Received Offer of $700 Million Clinics

Oct. 4 (Bloomberg) -- American Securities LLC, a New York- based private-equity firm, is the leading bidder for a U.S. chain of dental clinics owned by Friedman Fleischer & Lowe LLC with an offer of about $700 million, according to people with knowledge of the auction.

Friedman Fleischer owns two companies, NCDR LLC and DPMS Inc., that provide facilities and support staff to dental groups operating under the Kool Smiles brand, according to the San Francisco-based firm’s website. TPG Capital also submitted an offer in the final round of bidding, said the people, who asked not to be identified because the deal hasn’t been completed.

The two companies are not really two companies, it's Kool Smiles and Kool Smiles 2.  KS is the clinics in the East and KS2 are the western most clinics.

Read the full article here: Business Week

However since after time passes and the stinch of a company begins to fill the offices of these PE firms, stories like this seem to vanish from the Internet.  So in case that happens, here is the full story:

By Cristina Alesci, Jeffrey McCracken and Jason Kelly

Oct. 4 (Bloomberg) -- American Securities LLC, a New York- based private-equity firm, is the leading bidder for a U.S. chain of dental clinics owned by Friedman Fleischer & Lowe LLC with an offer of about $700 million, according to people with knowledge of the auction.

Friedman Fleischer owns two companies, NCDR LLC and DPMS Inc., that provide facilities and support staff to dental groups operating under the Kool Smiles brand, according to the San Francisco-based firm’s website. TPG Capital also submitted an offer in the final round of bidding, said the people, who asked not to be identified because the deal hasn’t been completed.

Rajat Duggal, a managing director at Friedman Fleischer, couldn’t be reached for comment. Officials for American Securities and TPG declined to comment.

Private-equity firms have resumed dealmaking after a two- year lull following the global financial crisis that started in mid-2007, freezing credit markets and ending the biggest leveraged-buyout boom in history. There were $59 billion in deals in the third quarter, more than triple the amount a year earlier, according to data compiled by Bloomberg.

American Securities, which was founded in 1947 by a Sears Roebuck & Co. heir, has invested in companies including vacuum- cleaner maker Oreck Corp. and the El Pollo Loco chain of chicken restaurants, according to its website. The firm was a runner-up at the recent sales of Air Medical Group Holdings Inc. and Aspen Dental Management Inc., both owned by private-equity firms, according to a person with knowledge of the sales.

Air Medical, Aspen Dental

Leonard Green & Partners, the Los Angeles-based private- equity firm, is buying Aspen Dental from Ares Management LLC. Bain Capital LLC, the Boston-based leveraged buyout-fund manager, is acquiring Air Medical from Brockway Moran & Partners Inc. and MVP Capital Partners.

Kool Smiles caters to children enrolled in Medicaid, a federal-state health insurance program for the poor, and other state health insurance plans, according to Friedman Fleischer’s website. Some firms that looked at Kool Smiles were concerned that it was too reliant on Medicaid payments as governments face deficits, said one person familiar with the auction.

Private-equity firms are increasingly buying companies from each other as more than half the companies that submitted plans for U.S. IPOs in 2010 have yet to complete them. Sales among buyout firms allow the seller to return cash to investors, while the acquirer is able to deploy unused capital that was raised during the boom. Clients saw distributions last year fall to the lowest level since at least 2000, according to London-based research firm Preqin.

Opening Clinics

Smile Brands Group Inc., a separate dental chain backed by private-equity firm Freeman Spogli & Co., scrapped an initial public offering in May. The company, which relies on patients with private insurance for most of its revenue, is now shopping itself in a sale process that is still in early stages, according to a person with knowledge of the matter.

American Securities plans to expand Kool Smiles’ main business of opening clinics in places where access to dentists and other medical services is limited, the person said.

TPG has been pursuing deals. The Fort Worth, Texas-based firm and Goldman Sachs Group Inc.’s buyout arm agreed in July to purchase Belgian diaper-maker Ontex NV for $1.55 billion from London-based private-equity firm Candover Investments Plc. TPG also acquired a 35 percent stake in Creative Artists Agency for an undisclosed amount in a deal announced Oct. 1.

Friedman Fleischer has more than $2 billion under management, according to its website. Its holdings include Korn/Ferry International, the executive-recruiting firm, and Montpelier Re Holdings Ltd., a Bermuda-based property reinsurance company.

--Editors: Elizabeth Wollman, Larry Edelman
To contact the reporters on this story: Cristina Alesci in New York at Calesci2@bloomberg.net; Jeffrey McCracken in New York at jmccracken3@bloomberg.net; Jason Kelly in New York at jkelly14@bloomberg.net.