Tuesday, January 17, 2012

My secret meeting with Todd R. Cruse of Small Smiles Dental-Church Street Health Management

On September 20, 2010, I received an email from Todd Cruse, Church Street Heath Management’s SVP of Development and Government Affairs.

“I’ll be in Kentucky next month. Any interest in having a cup of coffee and conversation?’

After a couple of days I finally responded, “I do apologize for taking so long to respond.  I've been seeing to my daughter and granddaughter.  I was about to reply to your suggestion today when I received a phone call from my attorney telling me Thor Urness wanted my attorney to call him. Upon hearing that, I thought I should wait to hear back from this conversation that Thor requested.  However, I've not heard back.  Until I hear what Thor wanted, I'm not comfortable granting your request for coffee and conversation. However, I do enjoy a good cup of coffee and am open for conversation.”

Thor Urness is the Nashville attorney who Church Street Health Management hired to harass me in the Federal Court system since November of 2008.

Todd responded back, “Thank you for your response. If at some point you become comfortable and would like to have that cup of coffee just let me know.”

By September 29, Thor had never returned the call my attorney had made to him, so I emailed Todd and we made arrangements to meet up for that “coffee and conversation” he so desired. 

Todd said in his return email, “I believe that Thor was following up on the posts that you have since removed so I don’t think Pat will be hearing from him. I am flexible as to where to meet. I have to run up to Bowling Green on Thursday to pick something up - Any interest in meeting me there. I believe there is a Starbucks right on 231 off of I-65 (Scottsville Rd I believe?).Thanks for reaching out.”  He closed the email with “TRC”.

I agreed and the meeting was set for 10 am Thursday October 7, 2010.

By the sound of things so far it appears that this “coffee and conversation” meeting would involve each of us driving a great distance doesn’t it?  In reality, it would only be a 50 minute drive for each of us.

I drove to Bowling Green (KY)the night before the big meeting and stayed all night.  I was up and off to Starbuck's early, I got there about 9 A.M. I wanted to be there well in advance to see who and what came with whom.  I had checked the place out the afternoon before and found the ideal seat to be in view of the security camera and be facing the entrance. I would never sit with my back to door when dealing with these people, maybe I’ve watched to many gangster movies.

I had clipped my cell phone to my laptop case and turned on the video. I set it on a couch that was a couple of feet to my left, so it looked like it belonged to someone else. I didn't have time or the opportunity to actually "aim" it, so all I got was a scratchy video of my ass sitting in the chair. But it sure was a damn good idea. Wish I had aimed it with better accuracy.

I was glad I got there early. I suspected Todd would not really be alone. I am sure I was right and they sent someone ahead to be a "lookout", a second set of eyes and ears. I came to this conclusion because a guy pulled up in a large black sedan, got out and came inside. Where I was sitting I could see the license plates of the vehicles, low and behold it was a Tennessee- Davidson County-license plate. The gentleman was dressed for the office for sure, thin and about 6 feet tall.

After he got his coffee, the guy looked around, he appeared lost.  It was like he didn't know what he should do next or waiting on someone in the bathroom or something. He stood in the ordering area a minute, walked up the steps to the seating area and still appeared to be "lost", certainly out of place. He sure didn't appear like he came in to grab a newspaper and sit down for a cup of “morning joe”.  He scanned the room and then picked up a flier of some kind and then sat down on the edge of a nice relaxing chair.  Still he looked out of place.

I had some documents and a news paper drinking coffee, blending in with the rest of the morning crowd. He sat where I could look him in the eye if he ever looked my way. He finally did, and I gestured and mouthed the words, "are you Todd"? 

Now, instead of answering like he wasn't sure what I was talking about (as I would) he immediately shook his head no. He was clear across the room and knew exactly what I had mouthed. He didn't even wrinkle his forehead in confusion. Right then he shot up out of the chair and left. I know dang well he was the "scout".

Right on schedule, just minutes before 10 A.M. Todd walked in, we locked eyes immediately, he grabbed a latte and came and introduced himself.  He was dressed semi-casual; khakis and a light blue shirt.  He walked with a “cool” swagger.  You could tell he was quite proud of the way he turned out. His demeanor also projected that he is used to massaging all kinds of personalities to get what he wants. I thought to myself he should be SVP- of "smooth" Operations.

My first words to him were, “You are going to find we agree on more than we disagree.” I was lying like a dog, no offensive to my canine friends. I was just trying to set a relaxing, and not so defensive tone, before the conversation got started.

He was there to sell Small Smiles and I wasn't buying. However, I was smelling what I was stepping in. I could have been anyone there that day; all he was there to do was convince me of his "passion" for helping the poor needy children. Somehow I knew he had this spiel down to a fine art and had given it a thousand and one times, I was just number one thousand and two.

We talked about the dental needs of less fortunate children, and we talked about the causes of children's poor dental health.  He told me how my blog could be very helpful in getting the right word out and promote dental health.  (Clearly he had me confused with an idiot)  He told me stories of children with rotten teeth and the bad mothers who fill their bottles with "Mountain Dew".  Yes, the usual “sippy cup” “bottle mouth” excuses all the dental mills use to justify their fraud and abuse.


Then he got to the meat of the meeting.  He asked what my "goal" was and how I became so involved. 

I told him every detail on how I became involved in this along, he also got to see the emotion that comes every single time I think about my grandson being strapped in that damn straight jacket. When I told him how I called everyone involved on the incident with my grandson he actually had a gleam in his evil eyes. He actually said he was glad I nailed those involved. I was surprised how happy it made him. It was a bit weird; he was actually giddy.

I didn't tell him my goal was to shut the bastards down, but I did tell him I wanted those papoose boards used a whole hell of a lot less.  He tried to justify its use, with the usual excuses; safety for the child, safety for the staff, blah blah blah. I called him on it with vigor; he bowed his head in retreat.  There was no doubt he knew this was a pile he didn’t want to step in, not right there is Starbucks. I was locked and loaded for this conversation and he wasn’t about to grant me the delight of aiming and firing.

When we were talking about the use of the papoose board, I let him know from the start I knew many of the state rules and regulations on its use. I tried to appear understanding that sometimes it was a necessary evil, however, I was clear about my feelings toward its use.

I told him I was aware, in many states, there was a time limit on how long a child can be strapped on the board, without a break.  I also let him know those laws had to be put in place because of the DeRose way of pediatric dentistry.  I knew he could care less, but I wanted to make sure he was aware I knew exactly what I was talking about and I wasn’t some “mouth from the south” ranting about something I knew nothing about; just in case he had me confused with someone else.

I also told him I knew they just go over the time limit on a regular basis and simply do not document it. I also let him know I knew many states pay for the use of the papoose board.

He then went into a lie that actually made his nose grow and damn near poked my eye out! 

Are you ready?

He told me they do NOT charge for use of the papoose board even though many states do reimburse for "Behavior Management" (dental code number D9920).

He said they decided early on not to charge the government for the use of the papoose board.  Not sure if “they” mean the Church Street Health Management bunch or old FORBA-the DeRose criminals, I mean clan. It didn't really matter since I knew he was lying.

He said “they” knew it would look bad and just wasn't right to use it and get paid for it.  He went on to say by not taking money for using it, they couldn't be accused of its overuse just for the money! Yes, he sure said it.

I didn’t tell him I had just seen exactly how much one state reimbursed them for the use of the papoose board. Sometimes it’s amusing to watch people like him spinning in their own shit. I wonder if they realize how foolish they look sitting in front of someone who knows they are lying with every breath.

At that moment I braced myself and expected the earth to open up and the whole building to fall into a black abyss. But that didn’t happen. He just continued with his lies and continued to look like an idiot.

He told me how much better Small Smiles Dental Centers were since Michael Lindley and Church Street Health Management had purchased the dental centers. He said Michael DeRose would cut costs everywhere, but now, with Michael Lindley at the helm, only top of the line equipment in the clinics including the waiting room chairs. He went on to tell him what a truly standup citizen Lindley was and what all he has done for the betterment of children. I began to look for a barf bag.

He said the use of the papoose board had dropped drastically since Church Street Health Management had taken over. I told him it was still used to much. Then he said, "well, it can't be fixed over night".

I had to drop my head so he didn't see the anger on my face on that one. I was thinking, yes, yes dumbass, it can be fixed over night; an email to each clinic right this second instructing them to throw each and every last one of them away would work just fine.  A bonfire would be good too.

It was all I could do to not stand up and scream, “Well, you've had 4 years and one month! How damn inefficient are you stupid assholes.” I regained my composure and looked him straight in the eye and said, “It is being used way too much, period and you know it.”

Knowing I am so passionate about the abuse of children, and seeing I’m not buying his snake oil.  Mr. Smooth then tried to convince me I was the one who was harming these precious children.

Todd told me what I was doing was in reality hurting the children who needed the care and treatment his company offered. He told me by using the dentists name on the blog, it was embarrassing the dentists among their peers; and it was making it more difficult to hire the "quality" dentists they otherwise would be able to hire.

Finally!  Confirmation I was meeting my goal! YES! I wonder if he saw the glint in my eyes? How could he miss it?

Then he started babbling, telling me how my blog doesn't really carry much weight with parents and patients and that regulatory agencies didn't give anything on the site much weight. I thought, ok, so it's powerful enough to make it hard to hire quality dentists, but it really is meaningless to everyone else-yeah ok, Todd, whatever! What about all the quality you just mentioned Michael Lindley and Al Smith brought to Small Smiles dental centers, huh? Surely my little ole blog can’t overwhelm these professionals.

Somehow Todd thought he would sway my thinking with the power of Church Street Health Management. He said that having them-Small Smiles-treat children was much better than these other local or state "doc in a box" operations-that's what he called them.  He even used South Texas Dental as an example. He told me he expected the smaller chains to close soon.  He said the smaller chains simply could not compete compete with their marketing machine.

He insisted that they are the safe way to go.  They have so many layers of "safety nets" and “layer upon layer of compliance assurances and advisory boards, and patient liaisons, and Dr. Stephen Adair and his outstanding respect in the dental community and more blah blah blah.

I corrected him and told him Dr. Adair had little respect anymore, he disagreed. I wish I had then, what I have now on Dr. Stephen Adair. 

He said if they see a "spike" in the use of the papoose board he immediately checked to see the circumstances etc. I was thinking when a gauge is "pegged" you can't tell if it spikes! Again, his nose lunged so far forward it hit the lady behind me in the back of the head. I swear I thought I smell the odor of Khaki pants burning, but there was no smoke coming from his seat that I could see.

Just months prior to this meeting there was an expressed concern at company headquarters over a couple of dental centers having possible “under-utilization” of the papoose board issues. Company officials wanted regional managers to look into the problem immediately.

He gave me kudos for my crusade and being so creative in handing out fliers in the parking lots of the clinics, but said it just wasn’t helpful to the children.

He also said he was advised not to do this meeting but decided to ignore the advice and just wanted to try a "little conversation".  Well, the company was advised not to pursue any legal avenues with me too, and they didn’t listen to that either.

I mentioned what a picture this would be for the blog, me and the “Toadster”- that’s what I call him- at a secret meeting! He told me much of what I hear comes from "disgruntled" employees and was most was just plain wrong. Telling me he was divorced was the topic here, or so it appeared, since it was the only thing on his list.

He told me in a few states these law firms were running ads and getting clients. He went on to tell me about all the requests they were getting for medical records and about 30% of the requests were for patients that were never patients of Small Smiles, and all of this is taking away from their passionate goal of serving the needy-his hand even went over his heart at this point. It was a poor performance of compassion at best.

He told me they are trying to get as many pediatric dentists as they can and I'm hurting that goal.  He said they were even offering a program for dentists to hire in and go the extra two years of training to become a pediatric dentist. In return, the dentist would have to sign up for a 3.5 year stint working for Small Smiles, in addition the dentists would be paid a nice stipend to live on while they continued their education.

Todd also told me how he ended up at old FORBA-the DeRose business.  They were his "client" when he was at Public Strategies and offered him a job.  He moved to Colorado for 3 years, and traveled 40 weeks of the year living out of a suitcase. He was about done with it, when they told him to hang on, something was coming up and it could get him back to Tennessee.  He said the Derose’s "owned" Pueblo-the city.  I knew what he meant.

Throughout the conversation he kept asking if he was going to see all of this on the blog or youtube the next day and I told him absolutely not. I also told him there was a whole lot of things I know that I “sit” on and never makes it to my blog. I saw an ever so slight flash of fear on his face which delighted me. 

Then he told me of the future plans. That is when the conversation turned much more serious. They were in the process of getting at least one dentist in each clinic "privileges" at a local surgery center or hospital where they can sedate the children, IV style and that a few were already doing this. They did not want to go the route of "Oral Conscious Sedation" I forgot the reason, because I was so distracted thinking of the "spike" in children's deaths.  I’m sure I have it on audio though, since the whole conversation was recorded.

I told him my serious concerns about this and questioned if it would always be in a health facility and reminded him of all the deaths in the past two years and especially the number in 2010.  He then said it would not always take place in an off-site facility due to several factors including backed up schedules for operating rooms and access to a facility for patients etc. 

He was quick to assure me that when this I.V. sedation is done in house there will be a licensed anesthesiologist and 2 registered nurses on site. I didn’t believe a word of it. Plus I've seen how that goes and it's not well, when they are in a hurry and stop by to sedate then leave. All I was thinking besides the parents sitting in the waiting rooms, and the ones who will see an ambulance arrive out front, was all the work they can do in one sitting, who is there to question the extent of work, and of course the increase in billable fees. Wonder how many will be unnecessarily hooked up to an I.V.?  A whole lot!

He asked me to give him a chance. (huh?) I had told him employees and parents are afraid to come forward and I end up getting an anonymous email about a situation. He then went into the all the things they have in place-The Hotline (which he said goes to an independent company in AZ), the "Patient Advocate" they have in place...blah blah. He asked if they next time I got a complaint, would I forward it on to him, let him see if he can fix it, etc. He told me even if I wanted to do it anonymously myself that would be fine, just use the website. He said those emails come directly to him.

That's pretty much our meeting. He got up, said goodbye, turned and walked toward the bathroom. That’s when I saw the long red tail hanging out his left pant leg.

Public Strategies, Inc. – WPP Group
98 San Jacinto Boulevard
Austin, Texas 78701
United States
Phone: 512-474-8848
Fax: 512-474-0120
From Businessweek website:

Todd Cruse served as Project Coordinator for TLC Corporation, where Mr. Cruse coordinated construction and remodeling projects focused on image renewal. Mr. Cruse served as a Senior Staff Member for former Tennessee Governor Don Sundquist and as the Governor's Chief Administrative Officer. In this capacity, Mr. Cruse was an Advisor to Sundquist, overseeing administrative and budget management, supervising the budget director, facilities manager, correspondence and personnel ... offices, and acting as a liaison with members of the governor's cabinet. Earlier, he held the cabinet position of assistant to the governor for legislation, in which he advised the administration on a wide range of legislative and public-policy issues, including criminal justice, healthcare, tax reform, transportation and welfare reform. He also functioned as the administration’s lead lobbyist, coordinating over 45 departmental legislative liaisons. Mr. Cruse serves as Director of Public Strategies Inc.

It’s a tangled web - these are some of Todd Cruse connections

Public Strategies – Todd Cruse still listed as a “director”
Former Tennessee Governor Don Sunquist
Robert Wendell Moore – Cruse and Moore both worked in Sunquist administration, both ended up at Public Strategies, Moore had a short run at Harold Ford Group.
The Harold Ford Group – owned by Harold Ford, brother of TN Senator John Ford
Senator John Ford - Todd Cruse and Dan DeRose had to testify at Senator John Ford’s trial
SCB Computer Technology – given largest share of state contracts under Sunquist administration; Moore and Sunquist worked as lobbyist together in 2002
SCB Computer Technology – ended up at Public Strategies with Cruse and Moore