NCDR, LLC–Kool Smiles-Resolution Dental wants you and your practice.

The private equity firm, FFL, who owns Kool Smiles Dental and Resolution Dental is moving away from opening their own clinics and moving toward the Heartland Dental business model—what I call the F & S business model. (S for suck, so you can figure out what the F stands for). 

F & S Business Model - This is where they come in, offer practice owners an unrealistic amount for their established practice, put the current owner and staff under employment contracts, then set unrealistic income quota’s that forces dentists and staff to make decisions not necessarily good for the patient. See A peek under the sheets of Heartland Dental

Rumors last years indicated Kool Smiles Dental had their highly questionable but lucrative Medicaid income stream reduced significantly due to what was apparently questionable dental treatment and billing practices. In 2013 they began switching many of their practices to Resolution Dental.

Now, they want to purchase already established dental centers. I’m sure this is a much faster way to increase the dwindling revenues.

They advertise:

Are you considering selling your practice? Let's talk.

They want locations “not in the hood” and are offering a “fast and furious” “too good to be true” amount cash for said locations. They want dentists willing to sign restrictive 2 years employment contracts, which will no doubt include a stiff penalties, especially for disparagement of the company. They also offer bribe your staff to stay on, but make no promises.

Any updates on Kool Smiles and Resolution Dental Clinics

I’ve not heard anything about this guys lately. Well, not since they sent warning letters out to current and past employees.

Anyone have any idea what’s happening down in Atlanta?

Pat on the Head or Slap on the Wrist

AG Gansler Secures Settlement from Baltimore County Dentist
Owner of Baltimore city practice must repay $25K to Medicaid program

Baltimore, MD (January 3, 2014) - Attorney General Douglas F. Gansler announced today that the State of Maryland has reached an agreement with Lisa Valentine, D.D.S., of Woodstock, for her to repay the Medicaid program $25,000 in civil damages for services that were billed, but never rendered. The Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General conducted an investigation into the practice of Dr. Valentine, which included numerous interviews with her former patients and staff.

"The hardworking taxpayers who fund the Medicaid program deserve to know that their money is benefiting those it is intended to help," said Attorney General Gansler. "Our office took swift and decisive action against this dentist who was trying to abuse the system."

The investigation showed that Dr. Valentine's husband, Spencer Brown, in his capacity as an employee of the practice, billed the Medicaid program for services that were not provided.

Brown previously pleaded guilty to one count of Medicaid fraud for submitting the fraudulent claims to the Medicaid program from January 2008 through November 2010. He received a sentence of five years incarceration, with all but one year suspended, and was ordered to pay restitution of $156,918 to the Medicaid program.

Attorney General Gansler thanked Assistant Attorneys General Tom Rafter and Shelly Martin, as well as Investigator Mark Holback, all of the Medicaid Fraud Control Unit, for their work on this case.

http://www.oag.state.md.us/Press/2014/010314.html

Thank you e-mails always appreciated

It all turned out well for this little 3 year old after panicked mom decided to do some research and ask questions.

January 15, 2014

Hi Debbie 

I just wanted to give you an update. I took my daughter for a second opinion. Syosset, NY.

I would have never imagined the dentist  would look like a housewife of Beverly Hills. But she had a brain, so that was great. 

She told me that my daughter DID NOT have three cavities in her mouth as indicated by the first dentist.

As you mentioned in our previous correspondence, it was deep groves and discoloration in her back teeth.

This doctor was able to get perfect images of the teeth. 

My daughter did have one cavity in the front which was a result of her teeth being too close together. 

The doctor advised it was too small to go through the trouble of filling it, gave my daughter a toothpaste that would slow the growth of the cavity and told me to bring her back in six months. 

Had I taken the other dentist word for it,  my daughter would have had work done on teeth that were perfectly fine. 

Sometimes, we doubt ourselves believing that these doctors are smarter than us, because they were able to study longer and go beyond four years of college.  Sometimes these doctors are overly confident in their craft, believing they aren't capable of making a mistake.  

Erasers and malpractice insurance was made for a reason. 

So, THANKS! for your blog. I hope other parents find it, read it and understand that it's okay to challenge the doctors.

Below is this thankful mother’s original email:

---

January 5, 2014

Hello

I have 4 four year old that was recently seen by a dentist.  I was told she has three cavities.  My heart dropped.  I wanted to cry for my daughter.  I am 34 years old and I HATE going to the dentist. 

After being told my daughter had cavities, I immediately went home and started to read.  The article of the day was a 3 year old in Hawaii that died from a cocktail of drug while at the dentist.  My heart sank even deeper.  I am dealing with so many things in my life but, the news of my baby having cavities has hands down been the worst.

What would be the proper procedure (in your opinion) for treating children so small with cavities? It seems as if death by the death is very common.

I don't want my child to be in pain and have a fear of the dentist however, i don't want her to be one of the unlucky children that don't make it out the chair.
Please respond. I look at my daughter and start to cry.

Indiana taxpayers pick up the tab for shafted Allcare Dental patients

Customers of Allcare Dental get money back

Updated: Thursday, January 16, 2014, 12:09 PM EST

INDIANAPOLIS (WISH) - Many patients who lost money when a dental business closed its doors without notice got some of their money back, Indiana Attorney General Greg Zoeller announced Thursday.

Allcare Dental closed in 2011, leaving customers in Avon, Evansville, Fort Wayne, Indianapolis, Lafayette, Mishawaka and Muncie without a provider and with a lot of questions.

The dental company declared bankruptcy. Eventually, the nearly 300 customers who filed complaints in Indiana received some or all of their money back. The patients lost anywhere from $69 to $9,125 but the state could only pay back a maximum of $3,000 per person by state statute.

---

Wonder if Greg is related to Linda Zoeller of Small Smiles fame?

Dr. Chris Salierno: Good Dentists Can Make Bad Decisions

Interview with Dr. Chris Salierno

By Michael W. Davis, DDS | January 9, 2013

 

 

Dr. Chris Salierno Introduction

Education
Dr. Salierno received his B.S. from Muhlenberg College and his D.D.S. from SUNY Stony Brook School of Dental Medicine. He completed his formal training at Stony Brook Hospital’s General Practice Residency program where he focused on implant prosthetics. Dr. Salierno practices general dentistry in Melville, New York. 

Leadership
Early in his career Dr. Salierno served as president of the American Student Dental Association. He has continued to lend his leadership skills to serve his colleagues, as well as the public, by serving on a variety of committees that promotes enhanced professional ethics for the dental profession—including advocacy for new dentists.

His published professional papers and educational lectures have elevated quality care in dentistry. He writes and lectures internationally on a variety of subjects including, implants, occlusion, TMJ disorders, and practice management.

Much of his lecture content is available on his blog, The Curious Dentist, which also features candid discussions about everyday dentistry. Dr. Salierno is  co-editor of The Surgical-Restorative Resource, which focuses on the team approach to complex dental care. He is a past Chair of the ADA New Dentist Committee, and is currently the President of the Suffolk County Dental Society.

 

Interview Questions

Dr. Davis: Dr. Salierno, your blog, “The Curious Dentist”—directed at our junior colleagues— is very eye opening. It is troubling to see the minefield recent dental  graduates often must navigate. Senior doctors like myself often have no idea what challenges our next generation of doctors are facing with future employers.

One example, of course, is transferring the tax burden of federal FICA taxes from the employer, to the employee dentist, therefore increasing the employer’s bottoms line. Employers habitually misclassifying “employees”, as “independent contractors”. This, of course, is illegal and in direct contradiction to well established and routinely enforced IRS Guidelines.  

We have seen employers configure employee dentist compensation, using a convoluted structure of percentage of collections or billable services which would require a doctorate degree in economics and quantum mechanics to decipher. In numbers of cases, employee dentists are not getting a fair deal. 

There is also indisputable evidence of the pressure experienced by our junior colleagues to provide high-skill services, such as molar endodontic therapy in a rapid cut-rate manner. None of this serves the best interest of the patient, nor the dental profession.

Dr. Salierno, could you please highlight a few of these problem areas for dentist employees. In fact, I’d love for you to publish a paper specific to these issues, and give a lecture to every senior dental school class, prior to graduation.

Dr. Salierno: I’ve actually participated in an initiative just like you’ve suggested. The ADA’s Success Program brings leaders into dental schools to give presentations on subjects like ethics, practice management, and career choices. Programs are offered for first through fourth year and I’m happy to say that the majority of schools take us up on it. The main message to students is that they are not alone, no matter what challenges may face them in the years to come.

The changing landscape of dental Medicaid: Part 2

By Michael W. Davis, DDS, DrBicuspid.com contributing writer
January 9, 2014 -- In the first of this two-part series, Dr. Davis explained how the present degree of dental Medicaid fraud, waste, and abuse is not sustainable and how it is slowly changing. Read that part here.

In reaction to the public's concern about the excessive abuse of child restraints, a number of Medicaid mills have jumped onto the conscious sedation bandwagon. The best option of treatment is to sedate in a hospital setting with IV sedation, a properly trained anesthesiologist to continually monitor the child's vital signs, with reversal medications at the ready, and the capability of nearly instantaneous airway resuscitation. Since Medicaid often doesn't pay adequately for hospital cases, the children's safety is too-often compromised.

Too often, the dentist has little-to-no advanced life support training. A child going into shock from an adverse drug reaction already has tiny blood vessels in which to attempt to stick an IV line. Their airway is small and often further compromised by enlarged tonsils, with a natural anatomy that already appears anatomically constricted and funnel-like.

I won't say it's not feasible to do this care properly, but a doctor has to deliver conscious sedation (often involving multiple drugs) and monitor all vital signs, while simultaneously roundhousing sedated children with steel crowns and pulpotomies. However, under the present Medicaid program, there are huge financial disincentives to provide this style of care properly. Corners get cut and children get harmed, too often permanently.

So, what is the fallout for the dental profession? Certainly the negative press has added a degree of distrust from the public. Trust is difficult to obtain and easily lost. And once lost, it's even more difficult to regain.

 

Read the rest of Part 2 by clicking here

The changing landscape of dental Medicaid: Part 1

The changing landscape of dental Medicaid: Part 1
By Michael W. Davis, DDS, DrBicuspid.com contributing writer

January 8, 2014 -- Some experts examining the Affordable Care Act (ACA) have estimated a 25% to 33% increase in eligibility. What they may miss is that enrollment eligibility for potential patients does not necessarily equate into actual patients having access to dental care. Eligibility for services is a different element than access to those services. While this makes perfect logic to small or large healthcare business owners or managers, it may be outside the comprehension abilities of Washington bureaucrats.

In 2007, the U.S. Health and Human Services Office of Inspector General (HHS-OIG) issued a troubling report, which stated 31% of reviewed dental Medicaid submissions were improper. Again, please take note of that number -- 31%!

That degree of dental Medicaid fraud, waste, and abuse is not sustainable. The taxpayer cannot and should not fund such a dysfunctional program, no matter how well intentioned. Throwing limited public money at problems of disadvantaged children with dental needs, without adequate oversight, regulation, and enforcement represents an abuse to the American taxpayer. That unfortunate reality is slowly changing

Read the entire story here

Crime Watch

In New Holland, Pennsylvania a woman admitted stealing $3,743 from the dental office of DRr. Robert-Bers Techer, where she was employed. She also altered some bookkeeping records so  family members could received $1,608 in dental treatment.  She has been arraigned and released on $25,000 bail and faces a preliminary hearing on January 16, 2013. Total $5,351.

In Maryland, Spencer Brown, husband of Lisa Valentine, DDS, who worked for the practice billed Medicaid for services that were never provided totally more than $156,000. Maryland’s Attorney General “settled” with Brown for $25,000 in damages and restitution of $156, 918 in restitution and will spend one year in jail. (probably less). 

Let’s see how it turns out for the lady in New Holland, Pennsylvania.

Corporate dentistry’s latest attempt to silence critics and trample on the 1st Amendment–Comfort Dental sues professors.

Dr. Melvin Ball is a part time professor at the University of Colorado School of Dental Medicine. In December 2013 Dr. Ball was speaking with colleagues in teacher’s lounge at the university. During the conversation it’s alleged Dr. Ball voiced his opinion and confusion about Comfort Dental’s business model. Outrageous! (sarcasm).  Comfort Dental is also targeting three other professors, Sally Preston, DMD; Thomas Borris, DDS, and James Woolum, DDS seeking $2.45 million in damages.

[My God, where were these campus speech police back in the 60’s.  Berkley would have to close the campus if professors weren’t allowed to voice their opinions!]

Comfort Dental and it’s founder, president and CEO Rick Kushner, feel “they” were defamed when Dr. Ball spoke of his own experience as a doctor of dentistry saying, “I know you cannot provide consistent, quality dental care when all you care about is your bottom line.”

[I use the word “feel” loosely, since I’m not sure how a corporation actually “feels” anything. ]

Comfort Dental is also claiming they suffered damages because Dr. Ball stated he “can’t understand how he [Kushner] gets away with it.” God help those of us who do not hold an MBA! Comfort Dental also claims they suffered damages when Dr. Ball invoked Godwin’s law; allegedly Dr. Ball referred to Kushner as being “like Hitler”.

[Don’t ya wonder who the snitch is or how many there are?  Must be several since they cover the entire campus apparently.  Oh, wait, was all this detail obtained from surveillance cameras?  Wouldn’t that be interesting.  hmm…   That could open up a while new area of law, criminal, tort and “s”ort…]

The complaint against Dr. Preston states she told her class it was typical of Comfort Dental dentist to do shoddy work after of her students related a story from a Comfort Dental patient who had come to the dental school’s emergency clinic for treatment after two trips to Comfort Dental where the patient was less than satisfied and left in pain.

[ I suspect any dental care provided by Dr. Rick A. Kushner would be highly illegal and unethical since his dental license is expired nearly 2 years ago – February 2012.]

3 year old Finley Boyle has died after careless sedation by dentist and staff in Hawaii dental office.

This is the saddest picture I think I’ve seen in many years and should be the one that comes to mind the next time ANY dentists want to sedate a child.  Sadly these deaths are more common than you may think.  In 2011 there were 8 that were reported, who knows how many were not.

On December 3, 2013 baby Finley was sedated at Island Dentistry for Children. Dr. Lilly Geyer was the dentist in charge, but who actually administered the deadly cocktail 5 different drugs?  According to court documents a “technician” gave Finley the lethal cocktail. Not surprising to those of us who watch this sort of news, questions have arisen as to the whether Finely actually needed the extensive treatment recommended at her November check-up by Dr. Geyer.

Court documents say when Dr. Lilly Geyer discovered Finley had gone into cardiac arrest, the doctor ran down the hall to a pediatrician’s office in the building to get him to come and perform CPR.

The AAPD Guidelines recommends vital signs should be monitored and documented at least every five minutes for patients who are sedated.  However, as was learned in the dental malpractice case in Syracuse, NY the AAPD guidelines are “options”.  Dentists on the stand testified under oath, the AAPD guidelines have little influence in the decisions many dentists make in treatment. (sorry, I tried not to do there)

According to the Boyle’s attorney, Rick Fried, only 3 notations were made as to Finley's vital signs and they went unchecked for 26 minutes after the technician sedated her.

I can only conclude Dr. Geyer and staff as careless idiots.

As promoted by the Raven Marie Blanco Foundation, every dentist office should be prepared to handle a medical emergency and recommends The Six Links of Survival. 

See the RMBF Public Service Announcement

However, dentists are fighting this “tooth and nail”.  State dental boards are doing little to protect the public and everything to make it easier for dentists to increase their income stream by offering sedation.

Below are several links to various stories, don’t miss out on the comments.  As you will see in the comments, the first thing people do is blame the victim or in this case the victim’s parents.  What is usually not stressed in the stories is that the child probably did NOT need such extensive treatment, if at all.